The Janus kinase (JAK) inhibitor ruxolitinib was U.S. Food and Drug Administration-approved for patients with high-risk myelofibrosis (MF) in 2011. Researchers sought to assess the “real-world” clinical experiences of patients with MF who are treated in the JAK inhibitor era. The results were published in Clinical Lymphoma, Myeloma & Leukemia.
Researchers evaluated patterns of care for older patients with MF before and after ruxolitinib approval. They evaluated the Surveillance, Epidemiology, and End Results-Medicare database, and assessed treatment patterns via Medicare Part B and D claims.
The study included 528 patients (median age at diagnosis, 76 years) diagnosed with MF between 2007 and 2015. Among 298 patients diagnosed in the ruxolitinib era (defined as 2012-2015), 113 (37.9%) used ruxolitinib. A similar number of users started ruxolitinib at 5, 10, 15, or 20 mg twice a day.
Among 31 patients starting at ruxolitinib 5 mg or less twice daily, 48.4% were unable to escalate the dose, and less than 11 users could increase the dose to the maximum 25 mg twice daily dose. Approximately half of ruxolitinib users took hydroxyurea and/or prednisone simultaneously. Median time on ruxolitinib was 11.9 months (interquartile range, 4.2-21.7 months).
“It would be important to optimize the use of ruxolitinib and develop new drugs that may be administered together with or after ruxolitinib to accomplish better outcomes in older patients with MF,” the researchers concluded.