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Customizing first-line BTK inhibitors for CLL
with Gilles Salles, Paolo Ghia, and Francesc Bosch
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Momelotinib in patients with MF and anemia: Subgroup analysis of the SIMPLIFY-2 trial
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The phase III SIMPLIFY-2 trial (NCT02101268) assessed momelotinib, a JAKi, vs BAT (88.5% continued ruxolitinib) in JAKi-experienced patients with MF.1 Results from this trial were previously reported by the MPN Hub. A post hoc descriptive analysis evaluated outcomes in two patient subgroups: patients with moderate-to-severe anemia, defined by baseline Hb <100 g/L, and patients who were not TI at baseline. Results from this analysis were published in Advances in Therapy by Harrison et al.1
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| Key learnings |
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Both patient subgroups showed superior anemia-related outcomes with momelotinib vs BAT; transfusion independence rates at Week 24 were higher in patients with baseline Hb <100 g/L (33.3% vs 12.8%) and in patients who were not TI at baseline (34.7% vs 3.0%). Additionally, mean Hb levels in both subgroups improved and remained higher with momelotinib, despite lower or comparable median transfusion rates through Week 24. |
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Switching to momelotinib improved anemia management without compromising spleen volume reduction or symptom control; splenic response rates were 9.1% vs 5.1% in patients with Hb <100 g/L and 9.7% vs 3.0% in non-TI patients, while symptom response rates were 32.3% vs 2.6% in patients with Hb <100 g/L and 29.2% vs 0% in non-TI patients. |
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Patients continuing BAT/ruxolitinib required additional anemia-supportive therapies such as ESAs; however, this approach provided limited anemia benefits and lower symptoms and spleen control compared with switching to momelotinib. |
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These findings suggest that switching to momelotinib instead of continuing ruxolitinib and using ESAs or other supportive therapies may be a more effective strategy for JAKi-experienced patients with MF who have moderate-to-severe anemia or are non-TI. |
Abbreviations: BAT, best available therapy; ESA, erythropoiesis-stimulating agent; Hb, hemoglobin; JAKi, Janus kinase inhibitor; MF, myelofibrosis; TI, transfusion-independent.
- Harrison CN, Vannucchi AM, Recher C, et al. Momelotinib versus continued ruxolitinib or best available therapy in JAK inhibitor-experienced patients with myelofibrosis and anemia: Subgroup analysis of SIMPLIFY-2. Adv Ther. 2024;41(9):3722-3735. DOI: 10.1007/s12325-024-02928-4
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