Ruxolitinib: a steroid sparing agent in chronic graft-versus-host disease

Bone Marrow Transplant. 2018 Jul;53(7):826-831. doi: 10.1038/s41409-017-0081-5. Epub 2018 Jan 24.

Abstract

Inhibition of the Janus-associated kinases (JAK) with ruxolitinib (RUX) reduces graft-versus-host disease (GVHD) in preclinical and clinical models. In total 19 allograft recipients with moderate/severe steroid-dependent chronic GVHD received RUX as ≥2nd line salvage. RUX was well tolerated, and led to complete/partial resolution of oral (92/7%), cutaneous (82/0%), hepatic (71/28%), gastro-intestinal (75/17%), musculoskeletal (33/67%), pulmonary (0/80%), scleroderma (0/75%), vaginal (0/75%), and ocular (0/100%) chronic GVHD. Overall 18 achieved partial response and 1 complete response according to NIH Consensus Criteria. Responses occurred early and were sustained which enabled discontinuation (68%) or reduction of steroids to physiologic doses (21%). We conclude that RUX is an effective steroid-sparing agent in chronic GVHD.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Female
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / pathology
  • Humans
  • Janus Kinases / pharmacology
  • Janus Kinases / therapeutic use*
  • Male
  • Middle Aged
  • Nitriles
  • Pyrazoles / pharmacology
  • Pyrazoles / therapeutic use*
  • Pyrimidines

Substances

  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib
  • Janus Kinases