Dr. Kiladjian on Improving Transfusion-Independence Rates With Momelotinib in Myelofibrosis

Jean-Jacques Kiladjian, MD, PhD, professor of clinical pharmacology, Paris Diderot University, consultant hematologist, head, Clinical Investigation Center, Saint-Louis Hospital, Paris, France, discusses the potential utility of momelotinib in improving transfusion-independence rates in myelofibrosis.

During the 2021 European Hematology Association Congress, findings from a subset analysis of the phase 3 SIMPLIFY-1 trial (NCT01969838) were presented in a virtual poster. The results demonstrated that treatment with momelotinib resulted in higher rates of transfusion independence at 24 weeks compared with treatment with ruxolitinib (Jakafi) in patients with JAK inhibitor–naïve myelofibrosis. Notably, this benefit was observed irrespective of baseline anemia, baseline platelet count, or baseline transfusion status.

Typically, patients with JAK inhibitor–naïve myelofibrosis are treated with ruxolitinib, says Kiladjian. However, ruxolitinib is associated with thrombocytopenia, so patients often have to dose reduce or stop treatment with ruxolitinib, Kiladjian explains. This limits the efficacy of ruxolitinib in terms of symptom control for splenomegaly and anemia, Kiladjian says.

Patients seem able to tolerate an effective dose of momelotinib without dose-limiting thrombocytopenia, which could allow them to derive splenic responses and transfusion independence, Kiladjian concludes.