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Momelotinib vs ruxolitinib in patients with MF by baseline hemoglobin levels: Exploratory post hoc analysis from SIMPLIFY-1

By Dylan Barrett

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Aug 21, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in myelofibrosis.


The phase III SIMPLIFY-1 trial (NCT01969838) evaluated momelotinib vs ruxolitinib in Janus kinase inhibitor (JAKi)-naïve patients with myelofibrosis (MF).1 The MPN Hub previously reported long-term outcomes and updated results from this trial. An exploratory post hoc analysis from this trial assessed the benefits of momelotinib in subgroups defined by baseline hemoglobin levels (moderate/severe anemia, <10 g/dL; mild anemia, ≥10 to <12 g/dL; nonanemic, ≥12 g/dL).1 Results from this analysis were published in Leukemia & Lymphoma by Gupta et al.1

Key learnings1
Momelotinib demonstrated an advantage in transfusion independence rates at Week 24 over ruxolitinib in anemic patients, particularly in the mildly anemic subgroup (moderate/severe anemia, 46.5% vs 26.6%; mild anemia, 80.8% vs 50.7%), while the benefit was less clear in nonanemic patients (78.6% vs 86.8%).
The safety profile of momelotinib remained consistent across the subgroups, with fewer key hematologic treatment-emergent adverse events, including anemia and thrombocytopenia, compared with ruxolitinib, potentially allowing for full-dose administration in more patients.
Momelotinib provided similar splenic response rates at Week 24 to ruxolitinib across all subgroups, but with the added benefit of better anemia management, highlighting its comprehensive efficacy in treating patients with MF.
These findings are consistent with the overall patient population of the SIMPLIFY-1 trial and suggest that momelotinib is a viable treatment option for patients with MF regardless of baseline hemoglobin levels, as it offers a balanced approach to managing anemia without compromising on spleen or symptom benefits.

References

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