Dr. Kuykendall on Choosing Ruxolitinib or Fedratinib in Myelofibrosis

Andrew T. Kuykendall, MD, assistant member, Department of Malignant Hematology, Moffitt Cancer Center, discusses the use of ruxolitinib (Jakafi) versus fedratinib (Inrebic) in patients with myelofibrosis.

Ruxolitinib is currently used in patients with intermediate- and high-risk disease as it has shown benefit in reducing disease-related symptoms and enlarged spleens. Although ruxolitinib has been shown to improve quality of life for patients, there is some debate regarding when to sequence the JAK1/JAK2 inhibitor.

In August 2019, fedratinib was approved in the same indication as ruxolitinib, Kuykendall says. Head-to-head comparison of the agents may provide insight into which patient populations will benefit more from one drug versus the other.

Notably, increased toxicity has been reported with fedratinib. These adverse events are mainly gastrointestinal in nature including nausea and diarrhea, Kuykendall concludes.