Real-world non-interventional long-term post-authorisation safety study of ruxolitinib in myelofibrosis.


Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
12 2020
Historique:
received: 16 01 2020
accepted: 16 04 2020
pubmed: 26 6 2020
medline: 24 3 2021
entrez: 26 6 2020
Statut: ppublish

Résumé

Primary objective of this non-interventional, post-authorisation safety study was to provide real-world safety data [incidence of adverse drug reactions (ADRs)/serious adverse events (SAEs)] on adult patients with myelofibrosis exposed/or not exposed to ruxolitinib. Key secondary objectives included the incidence/outcome of events of special interest (bleeding events, serious/opportunistic infections, second primary malignancies, and deaths). Overall, 462 patients were included [prevalent users = 260, new users = 32, non-exposed = 170 (inclusive of ruxolitinib-switch, n = 57)]. The exposure-adjusted incidence rates (per 100 patient-years) of ADRs (19·3 vs. 19·6) and SAEs (25·2 vs. 25·0) were comparable amongst new-users versus prevalent-users cohorts, respectively; most frequent ADRs across all cohorts included thrombocytopenia, anaemia, epistaxis, urinary tract infection, and herpes zoster. Anaemia, pneumonia, general physical health deterioration, sepsis, and death were the most frequent SAEs across all cohorts. Incidence rates of bleeding events (21·6) and serious/opportunistic infections (34·5) were higher in ruxolitinib-switch cohort versus other cohorts. The incidence rate of second primary malignancies was higher in the prevalent-users cohort (10·1) versus other cohorts. The observed safety profile of ruxolitinib in the present study along with the safety findings from the COMFORT/JUMP/EXPAND studies support the use of ruxolitinib for long-term treatment of patients with myelofibrosis.

Identifiants

pubmed: 32583458
doi: 10.1111/bjh.16729
doi:

Substances chimiques

Nitriles 0
Pyrazoles 0
Pyrimidines 0
ruxolitinib 82S8X8XX8H

Types de publication

Clinical Trial Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

764-774

Subventions

Organisme : Novartis Pharmaceuticals Corp.

Informations de copyright

© 2020 British Society for Haematology and John Wiley & Sons Ltd.

Références

Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391-405.
Barbui T, Thiele J, Gisslinger H, Kvasnicka HM, Vannucchi AM, Guglielmelli P, et al. The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion. Blood Cancer J. 2018b;8:15.
Naqvi K, Daver N, Pemmaraju N, Bose P, Garcia-Manero G, Cortes J, et al. Clinical use of ruxolitinib in an academic medical center in unselected patients with myeloproliferative neoplasms not on clinical study. Leuk Lymphoma. 2017;58:866-71.
Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia. 2008;22:14-22.
Abdel-Wahab OI, Levine RL. Primary myelofibrosis: update on definition, pathogenesis, and treatment. Annu Rev Med. 2009;60:233-45.
Campbell PJ, Green AR. The myeloproliferative disorders. N Engl J Med. 2006;355:2452-66.
Curto-Garcia N, Harrison CN. An updated review of the JAK1/2 inhibitor (ruxolitinib) in the Philadelphia-negative myeloproliferative neoplasms. Future Oncol. 2018;14:137-50.
Iurlo A, Cattaneo D. Treatment of myelofibrosis: old and new strategies. Clin Med Insights Blood Disord. 2017 [Epub ahead of print]. DOI: https://doi.org/10.1177/1179545X17695233.
Harrison C, Kiladjian JJ, Al-Ali HK, Gisslinger H, Waltzman R, Stalbovskaya V, et al. JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med. 2012;366:787-98.
Mesa RA, Yasothan U, Kirkpatrick P. Ruxolitinib. Nat Rev Drug Discov. 2012;11:103-4.
Verstovsek S, Mesa RA, Gotlib J, Levy RS, Gupta V, DiPersio JF, et al. A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. N Engl J Med. 2012;366:799-807.
Harrison CN, Vannucchi AM, Kiladjian JJ, Al-Ali HK, Gisslinger H, Knoops L, et al. Long-term findings from COMFORT-II, a phase 3 study of ruxolitinib vs best available therapy for myelofibrosis. Leukemia. 2016;30:1701-7.
Verstovsek S, Mesa RA, Gotlib J, Gupta V, DiPersio JF, Catalano JV, et al. Long-term treatment with ruxolitinib for patients with myelofibrosis: 5-year update from the randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial. J Hematol Oncol. 2017;10:55.
Barbui T, Tefferi A, Vannucchi AM, Passamonti F, Silver RT, Hoffman R, et al. Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia. 2018;32:1057-69.
Giezen TJ, Mantel-Teeuwisse AK, Straus SM, Egberts TC, Blackburn S, Persson I, et al. Evaluation of post-authorization safety studies in the first cohort of EU Risk Management Plans at time of regulatory approval. Drug Saf. 2009;32:1175-87.
European Medicines Agency (EMA).Post-authorisation safety studies (PASS), 2019. Available at: https://www.ema.europa.eu/en/human-regulatory/post-authorisation/pharmacovigilance/post-authorisation-safety-studies-pass-0. Accessed May 2020
European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). ENCePP Guide on Methodological Standards in Pharmacoepidemiology, 2018. Available at: http://www.encepp.eu/standards_and_guidances/methodologicalGuide.shtml. Accessed May 2020.
Barosi G, Mesa RA, Thiele J, Cervantes F, Campbell PJ, Verstovsek S, et al. Proposed criteria for the diagnosis of post-polycythemia vera and post-essential thrombocythemia myelofibrosis: a consensus statement from the International Working Group for Myelofibrosis Research and Treatment. Leukemia. 2008;22:437-8.
European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). ENCePP Identifier: 3296. Available at: http://www.encepp.eu/encepp/viewResource.htm?id=29298. Accessed June 17 2020.
Arana Yi C, Tam CS, Verstovsek S. Efficacy and safety of ruxolitinib in the treatment of patients with myelofibrosis. Future Oncol. 2015;11:719-33.
European Medicines Agency (EMA). JAKAVI® (ruxolitinib). Available at: https://www.ema.europa.eu/en/medicines/human/EPAR/jakavi. Accessed May 2020.
USA Food and Drug Administration. JAKAFI® (ruxolitinib) prescribing information. Incyte 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/202192s017lbl.pdf. Accessed May 2020.
Talpaz M, Paquette R, Afrin L, Hamburg SI, Prchal JT, Jamieson K, et al. Interim analysis of safety and efficacy of ruxolitinib in patients with myelofibrosis and low platelet counts. J Hematol Oncol. 2013;6:81.
Al-Ali HK, Foltz L, Palumbo GA, Martino B, Palandri F, Liberati AM, et al. Primary analysis of JUMP, a Phase 3b, expanded-access study evaluating the safety and efficacy of ruxolitinib in patients with myelofibrosis (N = 2233). Blood 2017;130 (Suppl. 1):4204.
Al-Ali HK, Griesshammer M, le Coutre P, Waller CF, Liberati AM, Schafhausen P, et al. Safety and efficacy of ruxolitinib in an open-label, multicenter, single-arm phase 3b expanded-access study in patients with myelofibrosis: a snapshot of 1144 patients in the JUMP trial. Haematologica. 2016;101:1065-73.
Galli S, McLornan D, Harrison C. Safety evaluation of ruxolitinib for treating myelofibrosis. Expert Opin Drug Saf. 2014;13:967-76.
Vannucchi AM, Te Boekhorst PA, Harrison CN, He G, Caramella M, Niederwieser D, et al. EXPAND, a dose-finding study of ruxolitinib in patients with myelofibrosis and low platelet counts: 48-week follow-up analysis. Haematologica. 2019;104:947-54.
Verstovsek S, Gotlib J, Gupta V, Atallah E, Mascarenhas J, Quintas-Cardama A, et al. Management of cytopenias in patients with myelofibrosis treated with ruxolitinib and effect of dose modifications on efficacy outcomes. Onco Targets Ther. 2013;7:13-21.
Hultcrantz, M, Lund, SH, Andersson, TL, Bjorkholm M, Kristinsson, SY Myeloproliferative neoplasms and infections; a population-based study on 9,665 patients with myeloproliferative neoplasms diagnosed in Sweden 1987-2009. Haematologica. 2015;100:260.
Polverelli N, Breccia M, Benevolo G, Martino B, Tieghi A, Latagliata R, et al. Risk factors for infections in myelofibrosis: role of disease status and treatment. A multicenter study of 507 patients. Blood 2015;126:1606.
Polverelli N, Palumbo GA, Binotto G, Abruzzese E, Benevolo G, Bergamaschi M, et al. Epidemiology, outcome, and risk factors for infectious complications in myelofibrosis patients receiving ruxolitinib: a multicenter study on 446 patients. Hematol Oncol. 2018;36:561-9.
Vandenbroucke J, Pearce N. Point: incident exposures, prevalent exposures, and causal inference: does limiting studies to persons who are followed from first exposure onward damage epidemiology? Am J Epidemiol. 2015;182:826-33.

Auteurs

Fiorenza Barraco (F)

Centre Hospitalier Lyon Sud, Pierre-Bénite, France.

Richard Greil (R)

Salzburg Cancer Research Institute, Paracelsus Medical University Salzburg, Cancer Cluster Salzburg, Salzburg, Austria.

Raoul Herbrecht (R)

Inserm, Hôpitaux Universitaires de Strasbourg and Université de Strasbourg, Strasbourg, France.

Burkhard Schmidt (B)

Gemeinschaftspraxis Hämato-Onkologie, Munich, Germany.

Andreas Reiter (A)

Universitätsklinikum Mannheim, Mannheim, Germany.

Wolfgang Willenbacher (W)

Universitaetsklinik Innsbruck, Innsbruck, Austria.
Oncotyrol, Center for Personalized Cancer Medicine, Innsbruck, Austria.

Reinier Raymakers (R)

University Medical Center Utrecht, Utrecht, The Netherlands.

Rüdiger Liersch (R)

Internal Medicine Hematology and Oncology, Studienzentrale GEHO, Muenster, Germany.

Monika Wroclawska (M)

Novartis AG, Basel, Switzerland.

Robert Pack (R)

Novartis AG, Basel, Switzerland.

Karin Burock (K)

Novartis AG, Basel, Switzerland.

Divyadeep Karumanchi (D)

Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.

Heinz Gisslinger (H)

Department of Hematology and Blood Coagulation, Medical University of Vienna, Vienna, Austria.

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