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Ruxolitinib for the treatment of MF in clinical routine: Initial results from a phase IV study

By Jen Wyatt Green

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Sep 19, 2025

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


Results from the phase IV non-interventional JAKoMo trial (NCT05044026) evaluating real-world ruxolitinib treatment outcomes in 943 patients with myelofibrosis (MF) (Arm A, ruxolitinib-naïve patients, n = 479; Arm B, ruxolitinib-experienced patients, n = 464) were published by Koschmieder et al. in the European Journal of Haematology.

Key data

  • Ruxolitinib-naïve patients showed rapid (≤6 months), sustained improvements in spleen length (mean decrease from 19.0 cm to 16.89 cm at 12 months), constitutional symptoms, and quality of life (QoL) measures (~17% increase in the proportion of patients experiencing normal German QoL during follow-up in both arms).
  • Adverse events (AEs) were less frequent than in registrational trials, with lower rates of anemia (24% vs 32%), reduced hemoglobin (7% vs 12%), and thrombocytopenia (12% vs 29%) in ruxolitinib-experienced vs -naïve patients.
  • OS at 36 months (75%) was comparable to phase III COMFORT trial data.

Key learning

Real-world ruxolitinib treatment demonstrates significant and sustained clinical benefits for patients with MF, with maximum responses achieved within 6 months, supporting more conservative dosing strategies that maintain efficacy while potentially reducing AEs compared with clinical trial protocols.

References

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If you use erythropoiesis-stimulating agents (ESA) in the management of myelofibrosis, do you primarily base your use of ESA on patients’ erythropoietin (EPO) levels?