Momelotinib beats controls regarding transfusion outcomes in myelofibrosis

In JAK inhibitor-naïve participants with myelofibrosis, treatment with momelotinib improved red blood cell (RBC) transfusion intensity and zero RBC transfusion status compared with ruxolitinib. Furthermore, in JAK inhibitor-experienced participants, momelotinib was associated with larger reductions in RBC transfusion burden compared with danazol.

The JAK1/JAK2/activin A receptor 1 inhibitor momelotinib is an FDA-approved therapy for patients with myelofibrosis and anaemia. Prof. Ruben Mesa (Wake Forest Baptist Comprehensive Cancer Center, NC, USA) and co-investigators assessed the changes in transfusion intensity in participants with JAK inhibitor-naïve and -experienced myelofibrosis when treated with momelotinib in the phase 3 Simplify-1 trial (NCT01969838, n=432 JAK inhibitor-naïve participants, control: ruxolitinib) and phase 3 MOMENTUM trial (NCT04173494, n=195 JAK inhibitor-experienced participants, control: danazol) [1].

Simplify-1: At baseline, 70% (150/218) of the participants in the momelotinib arm and 75% (163/216) in the control/ruxolitinib arm did not require RBC transfusion per 28 days. In the momelotinib arm, 95% of the JAK inhibitor-naïve participants maintained this status, compared with 57% in the ruxolitinib group. In addition, 67% of the participants maintained and 19% had improved RBC transfusion intensity when treated with momelotinib, compared with 44% and 11% in the ruxolitinib arm. The mean RBC transfusion burden per 28 days decreased by 0.10 units upon momelotinib treatment and increased by 0.39 units in the ruxolitinib arm.

MOMENTUM: In JAK inhibitor-experienced participants, 20% in the momelotinib arm and 17% in the danazol arm required zero units of RBC transfusion per 28 days at baseline. In total, 92% and 64% of participants maintained this status during treatment for momelotinib and danazol, respectively. Furthermore, 19% maintained and 65% experienced improvement in RBC transfusion intensity when treated with momelotinib compared with 11% and 52% in the danazol arm. Finally, the mean transfusion burden decreased by 0.86 units per 28 days in the momelotinib arm and by 0.28 units per 28 days in the danazol arm.

These data demonstrate that across the 2 trials, over 85% of the participants treated with momelotinib maintained or experienced improved transfusion intensity compared with baseline, demonstrating that this agent delivers anaemia benefits for patients with myelofibrosis.

1. Mesa R, et al. Longitudinal assessment of transfusion intensity in patients with JAK inhibitor-naive or -experienced myelofibrosis treated with momelotinib in the phase 3 SIMPLIFY-1 and MOMENTUM trials. Abstract 3182, 65^th ASH Annual Meeting, 9–12 December 2023, San Diego, CA, USA.

 

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Posted on 7 February 20247 February 2024