Which patients with myelofibrosis should receive ruxolitinib therapy?: ELN-SIE evidence-based recommendations

Which patients with myelofibrosis should receive ruxolitinib therapy? : ELN-SIE evidence-based recommendations

Ruxolitinib is an oral Janus-activated kinase 1 (JAK1)/JAK2 inhibitor approved for the treatment of patients with myelofibrosis based on the results of two randomized clinical trials. However, discordant indications were provided by regulatory agencies and scientific societies for selecting the most appropriate candidates to this drug. The European LeukemiaNet and the Italian Society of Hematology shared the aim of building evidence-based recommendations for the use of ruxolitinib according to the GRADE methodology. Eighteen patient-intervention-comparator-outcome profiles were listed, each of them comparing ruxolitinib to other therapies with the aim of improving one of the three clinical outcomes: (a) splenomegaly, (b) disease-related symptoms, and (c) survival. Ruxolitinib was strongly recommended for improving symptomatic or severe (415 cm below the costal margin) splenomegaly in patients with an International Prognostic Scoring System (IPSS)/dynamic IPSS risk intermediate 2 or high. Ruxolitinib was also strongly recommended for improving systemic symptoms in patients with an MPN10 score 444, refractory severe itching, unintended weight loss not attributable to other causes or unexplained fever. Because of weak evidence, the panel does not recommend ruxolitinib therapy for improving survival. Also, the recommendations given above do not necessarily apply to patients who are candidates for allogeneic stem cell transplant.

Barosi, G.IRCCS Policlin San Matteo Fdn, Pavia, Italy. (författare)
Cervantes, F.Hosp Clin Barcelona, IDIBAPS, Barcelona, Spain. (författare)
Birgegård, Gunnar,1944-Uppsala universitet,Hematologi,Univ Uppsala Hosp, Uppsala, Sweden.(Swepub:uu)gunnarbg (författare)
Griesshammer, M.Johannes Wesling Klinikum Minden, Minden, Germany. (författare)
Harrison, C.Guys & St Thomas NHS Fdn, London, England. (författare)
Hehlmann, R.Heidelberg Univ, Med Fak Mannheim, Mannheim, Germany. (författare)
Kiladjian, J-JCtr Invest Clin CIC 1427, Paris, France. (författare)
Kroeger, N.Univ Hosp Hamburg Eppendorf, Hamburg, Germany. (författare)
McMullin, M. F.Queens Univ Belfast, Belfast, Antrim, North Ireland. (författare)
Passamonti, F.Univ Florence, Dept Expt & Clin Med, Florence, Italy. (författare)
Vannucchi, A.Osped Circolo & Fdn Macchi, Varese, Italy. (författare)
Barbui, T.Osped Papa Giovanni XXIII, Res Fdn, Bergamo, Italy. (författare)
Osped Cardinal Massaia, Asti, Italy.IRCCS Policlin San Matteo Fdn, Pavia, Italy. (creator_code:org_t)

Ingår i:Leukemia: Springer Science and Business Media LLC31:4, s. 882-8880887-69241476-5551

Av författaren/redakt...: Marchetti, M.; Barosi, G.; Cervantes, F.; Birgegård, Gunna ...; Griesshammer, M.; Harrison, C.; visa fler...; Hehlmann, R.; Kiladjian, J-J; Kroeger, N.; McMullin, M. F.; Passamonti, F.; Vannucchi, A.; Barbui, T.; visa färre...

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