Ruxolitinib (Jakafi)

Indications

Alopecia Areata (see xxxx)

  • xxx

Myelofibrosis (see Primary Myelofibrosis)

  • xxxx

Polycythemia Vera (see Polycythemia Vera)

  • xxx

Psoriasis (see Psoriasis)

  • xxxx

Rheumatoid Arthritis (RA) (see Rheumatoid Arthritis)

  • xxxx

Chronic Graft vs Host Disease (GVHD) (see Graft vs Host Disease)

  • xxxx
    REACH3 Trial (NEJM 2021)

Pharmacology

Metabolism

  • xxxx

Administration

  • xxxx

Dose Adjustment

  • Hepatic:
  • Renal:

Adverse Effects

Hematologic Adverse Effects

Infectioius Adverse Effects

Pulmonary Adverse Effects

  • Pneumonitis/Acute Respiratory Distress Syndrome (ARDS) (see Acute Respiratory Distress Syndrome)
    • Epidemiology
      • Case Reports Associated with Ruxolitinib Usage (Respir Med Case Rep, 2017) [MEDLINE]
      • Multiple Case Reports Associated with Ruxolitinib Withdrawal Syndrome (Int J Hematol, 2014) [MEDLINE] (Oncologist, 2021) [MEDLINE]
  • Cryptococcosis (see Cryptococcosis)
    • Epidemiology
      • Case Reports (Chest, 2013) [MEDLINE] (Respir Med Case Rep, 2017) [MEDLINE]
  • Exacerbation of Pulmonary Hypertension (see Pulmonary Hypertension)
    • Epidemiology
      • Case Report (Haematologica, 2015) [MEDLINE]
  • Pleural Effusion (see xxxx)
    • Epidemiology
      • Reported in Association with Ruxolitinib Withdrawal Syndrome (Mayo Clin Proc, 2011) [MEDLINE]
  • Pneumocystis Jirovecii Pneumonia (see Pneumocystis Jirovecii)
    • Epidemiology
      • Case Reports (BMJ Case Rep, 2014) [MEDLINE] (Am J Hematol, 2018) [MEDLINE]
  • Tuberculosis (see Tuberculosis)
    • Epidemiology
      • Multiple Case Reports (Am J Hematol, 2018) [MEDLINE]

Other Adverse Effects

  • Ruxolitinib Withdrawal Syndrome
    • Epidemiology
      • Occurs from 1 Day-3 wks Following Ruxolitinib Withdrawal
    • Physiology
      • Due to Abrupt Rebound in Serum Concentrations of IL-6, TNFα, and Macrophage Inflammatory Protein 1B

References

  • Serious adverse events during ruxolitinib treatment discontinuation in patients with myelofibrosis. Mayo Clin Proc 2011;86:1188–1191 [MEDLINE]
  • JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med 2012;366:787–798
  • A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. N Engl J Med 2012;366:799–807
  • Disseminated tuberculosis in a patient treated with a JAK2 selective inhibitor: a case report. BMC Res Notes. 2012 Oct 5;5:552. doi: 10.1186/1756-0500-5-552 [MEDLINE]
  • Efficacy, safety and survival with ruxolitinib in patients with myelofibrosis: results of a median 2-year follow-up of COMFORT-I. Haematologica 2013;98: 1865–1871
  • Ruxolitinib withdrawal syndrome leading to tumor lysis. J Clin Oncol 2013;31:e430–e432
  • An opportunistic infection associated with ruxolitinib, a novel janus kinase 1,2 inhibitor. Chest. 2013 May;143(5):1478-1479. doi: 10.1378/chest.12-1604 [MEDLINE]
  • Disseminated tuberculosis associated with ruxolitinib. Leukemia. 2014 Aug;28(8):1750-1. doi: 10.1038/leu.2014.104. Epub 2014 Mar 13 [MEDLINE]
  • Recurrent hypoxemic respiratory failure. Beyond the usual suspects. Ann Am Thorac Soc. 2014 Sep;11(7):1145-8. doi: 10.1513/AnnalsATS.201403-127CC [MEDLINE]
  • Acute respiratory distress syndrome in a patient with primary myelofibrosis after ruxolitinib treatment discontinuation. Int J Hematol. 2014 Nov;100(5):498-501. doi: 10.1007/s12185-014-1628-5. Epub 2014 Jul 18 [MEDLINE]
  • Pneumocystis jiroveci pneumonitis complicating ruxolitinib therapy. BMJ Case Rep. 2014 Jun 2;2014. pii: bcr2014204950. doi: 10.1136/bcr-2014-204950 [MEDLINE]
  • Pulmonary arterial hypertension exacerbated by ruxolitinib. Haematologica. 2015 Jun;100(6):e244-5. doi: 10.3324/haematol.2014.120816. Epub 2015 Feb 14 [MEDLINE]
  • Recurrent hypoxemic respiratory failure. Beyond the usual suspect. Ann Am Thorac Soc. 2014 Sep;11(7):1145-8. doi: 10.1513/AnnalsATS.201403-127CC [MEDLINE]
  • Pulmonary tuberculosis reactivation following ruxolitinib treatment in a patient with primary myelofibrosis. Leuk Lymphoma. 2015 May;56(5):1528-9. doi: 10.3109/10428194.2014.963082. Epub 2014 Nov 5 [MEDLINE]
  • Ruxolitinib-associated tuberculosis: a case of successful ruxolitinib rechallenge. Ann Hematol. 2015 Mar;94(3):519-20. doi: 10.1007/s00277-014-2183-0. Epub 2014 Aug 30 [MEDLINE]
  • Ruxolitinib versus standard therapy for the treatment of polycythemia vera. N Engl J Med. 2015 Jan 29;372(5):426-35. doi: 10.1056/NEJMoa1409002 [MEDLINE]
  • Reactivation of Pulmonary Tuberculosis following Treatment of Myelofibrosis with Ruxolitinib. Case Rep Hematol. 2016;2016:2389038. Epub 2016 Oct 23 [MEDLINE]
  • Pulmonary cryptococcosis in a ruxolitinib-treated patient with primary myelofibrosis. Respir Med Case Rep. 2017 Jul 4;22:87-90. doi: 10.1016/j.rmcr.2017.06.015. eCollection 2017 [MEDLINE]
  • Acute respiratory distress syndrome; A rare complication caused by usage of ruxolitinib. Respir Med Case Rep. 2017 Sep 18;22:243-245. doi: 10.1016/j.rmcr.2017.09.003. eCollection 2017 [MEDLINE]
  • Ruxolitinib-associated infections: A systematic review and meta-analysis. Am J Hematol. 2018 Mar;93(3):339-347. doi: 10.1002/ajh.24976 [MEDLINE]
  • Hypoxemic Respiratory Failure Following Ruxolitinib Discontinuation in Allogeneic Hematopoietic Cell Transplantation Recipients. Oncologist. 2021 Jul 17. doi: 10.1002/onco.13903 [MEDLINE]