Safety and efficacy of ruxolitinib in myelofibrosis patients without splenomegaly

Palandri, Francesca; Polverelli, Nicola; Breccia, Massimo; Nicolino, Barbara; Vitolo, Umberto; Cavo, Michèle; Vianelli, Nicola; Benevolo, Giulia

doi:10.1111/bjh.13758

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…disorders, in which adverse events, particularly those that are hematologically related, are understandably more frequent (11)(12)(13), and are consistent with findings from use of tofacitinib in the treatment of patients with psoriasis (14)(15)(16)(17)(18)(19). The occurrence of hair shedding in responders following drug cessation suggests that maintenance therapy may be required to sustain remissions.…”

Section: L I N I C a L M E D I C I N Esupporting

confidence: 75%

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Mackay‐Wiggan¹,

Jabbari²,

Nguyen³

et al. 2016

JCI Insight

243

202

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IntroductionAlopecia areata (AA) is a major medical problem and is among the most prevalent autoimmune disease in the US, with a lifetime risk of 1.7% (1). AA affects both sexes across all ethnicities and represents the second most common form of human hair loss, second only to androgenetic alopecia (2). AA usually presents with patchy hair loss. One-third of these patients will experience spontaneous remissions within the first year. However, many patients' disease will progress to alopecia totalis (AT, total scalp hair loss) or alopecia universalis (AU, loss of all body hair). Persistent moderate-to-severe AA causes significant disfigurement and psychological distress in affected individuals (3). In clinical practice, there are no evidence-based treatments for AA (4), yet various treatments are offered, most commonly topical and intralesional steroids, which have limited efficacy.Our recent mechanistic studies demonstrated a dominant role for type I cellular immunity in AA pathogenesis, mediated by IFN-γ-producing NKG2D-bearing CD8 + cytotoxic T lymphocytes (CTLs) (5). The central role of type I cellular immunity is also reflected in the transcriptional landscape of AA lesional skin in humans and mice, which is dominated by IFN response genes and a CTL signature. These findings provided BACKGROUND. Alopecia areata (AA) is a common autoimmune disease with a lifetime risk of 1.7%; there are no FDA-approved treatments for AA. We previously identified a dominant IFN-γ transcriptional signature in cytotoxic T lymphocytes (CTLs) in human and mouse AA skin and showed that treatment with JAK inhibitors induced durable hair regrowth in mice by targeting this pathway. Here, we investigated the use of the oral JAK1/2 inhibitor ruxolitinib in the treatment of patients with moderate-to-severe AA.

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Section: L I N I C a L M E D I C I N Esupporting

confidence: 75%

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Mackay‐Wiggan¹,

Jabbari²,

Nguyen³

et al. 2016

JCI Insight

243

202

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“…Overall, infections were fatal in 9% of the cases. Finally, in 70 patients with MF at lower risk (intermediate-1) treated with ruxolitinib [184], after a median time of 8 months from the start of ruxolitinib, infectious complications >grade 2 were 15.9%, and were mainly bacterial (with one bone TB infection) and viral infections.…”

Section: Molecular Targeted Agents (Ibrutinib Idelalisib Hdac Inhibmentioning

confidence: 99%

“…The notification of TB cases in registry data [177, 178] and other studies [180, 183, 184] as well as case reports [205–213] have suggested a causative role of ruxolitinib in the emergence of tuberculosis. Before ruxolitinib treatment, an accurate TB history should be always taken, and the screening for latent TB must be considered if epidemiological risk factors are significant (history, endemic areas, trips in endemic areas) with Tuberculin Skin Test (TST) or (preferably) IFN-γ Release Assay, IGRA (i.e.…”

Section: Molecular Targeted Agents (Ibrutinib Idelalisib Hdac Inhibmentioning

confidence: 99%

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

et al. 2019

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A multitude of new agents for the treatment of hematologic malignancies has been introduced over the past decade. Hematologists, infectious disease specialists, stem cell transplant experts, pulmonologists and radiologists have met within the framework of the European Conference on Infections in Leukemia (ECIL) to provide a critical state-of-the-art on infectious complications associated with immunotherapeutic and molecular targeted agents used in clinical routine. For brentuximab vedotin, blinatumomab, CTLA4- and PD-1/PD-L1-inhibitors as well as for ibrutinib, idelalisib, HDAC inhibitors, mTOR inhibitors, ruxolitinib, and venetoclax, a detailed review of data available until August 2018 has been conducted, and specific recommendations for prophylaxis, diagnostic and differential diagnostic procedures as well as for clinical management have been developed.

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“…Lung infections are frequent sequelae of aggressive immunosuppressive regimens. The conventional chemotherapeutic agents as well as molecular-targeted therapies may promote recalcitrant and sometimes life-threatening opportunistic pneumonias [60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77]. Increased infection risk in this setting is primarily due to the development of drug-related neutropenia, lymphopenia, and/or impairment of T cell and B cell function.…”

Section: Specific Clinical and Histopathologicmentioning

confidence: 99%

Cancer Treatment-Related Lung Injury

Shannon¹

2019

Oncologic Critical Care

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Safety and efficacy of ruxolitinib in myelofibrosis patients without splenomegaly

Cited by 7 publications

References 3 publications

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

Cancer Treatment-Related Lung Injury

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