TY - JOUR
T1 - Efficacy, safety and survival with ruxolitinib in patients with smyelofibrosis
T2 - Results of a median 2-year follow-up of COMFORT-I
AU - Verstovsek, Srdan
AU - Mesa, Ruben A.
AU - Gotlib, Jason
AU - Levy, Richard S.
AU - Gupta, Vikas
AU - Dipersio, John F.
AU - Catalano, John V.
AU - Deininger, Michael W.N.
AU - Miller, Carole B.
AU - Silver, Richard T.
AU - Talpaz, Moshe
AU - Winton, Elliott F.
AU - Harvey, Jimmie H.
AU - Arcasoy, Murat O.
AU - Hexner, Elizabeth O.
AU - Lyons, Roger M.
AU - Paquette, Ronald
AU - Raza, Azra
AU - Vaddi, Kris
AU - Erickson-Viitanen, Susan
AU - Sun, William
AU - Sandor, Victor
AU - Kantarjian, Hagop M.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - COMFORT-I is a randomized, double-blind, placebo-controlled trial of the Janus kinase 1/Janus kinase 2 inhibitor ruxolitinib in 309 patients with intermediate-2 or high-risk myelofibrosis. This analysis of COMFORT-I describes the long-term efficacy and safety of ruxolitinib (median follow-up, 2 years). Spleen volume was measured by magnetic resonance imaging, and quality of life was evaluated using the EORTC QLQ-C30. Overall survival was determined according to randomized treatment group. At the time of this analysis, 100 of 155 patients randomized to ruxolitinib were still receiving treatment. All patients randomized to placebo crossed over to ruxolitinib or discontinued within 3 months of the primary analysis (median time to crossover, 41 weeks). Mean spleen volume reductions in the ruxolitinib group were 31.6% at week 24 and 34.9% at week 96; improvements in quality of life measures were also maintained. Improved survival was observed for ruxolitinib (n=27 deaths) versus placebo (n=41 deaths) (hazard ratio=0.58; 95% confidence interval: 0.36, 0.95; P=0.03). The incidence of new-onset grade 3 or 4 anemia and thrombocytopenia decreased over time to levels observed in patients receiving placebo. These data indicate that ruxolitinib treatment provides durable reductions in spleen volume and improvements in quality of life and suggest a continued survival advantage for ruxolitinib over placebo.
AB - COMFORT-I is a randomized, double-blind, placebo-controlled trial of the Janus kinase 1/Janus kinase 2 inhibitor ruxolitinib in 309 patients with intermediate-2 or high-risk myelofibrosis. This analysis of COMFORT-I describes the long-term efficacy and safety of ruxolitinib (median follow-up, 2 years). Spleen volume was measured by magnetic resonance imaging, and quality of life was evaluated using the EORTC QLQ-C30. Overall survival was determined according to randomized treatment group. At the time of this analysis, 100 of 155 patients randomized to ruxolitinib were still receiving treatment. All patients randomized to placebo crossed over to ruxolitinib or discontinued within 3 months of the primary analysis (median time to crossover, 41 weeks). Mean spleen volume reductions in the ruxolitinib group were 31.6% at week 24 and 34.9% at week 96; improvements in quality of life measures were also maintained. Improved survival was observed for ruxolitinib (n=27 deaths) versus placebo (n=41 deaths) (hazard ratio=0.58; 95% confidence interval: 0.36, 0.95; P=0.03). The incidence of new-onset grade 3 or 4 anemia and thrombocytopenia decreased over time to levels observed in patients receiving placebo. These data indicate that ruxolitinib treatment provides durable reductions in spleen volume and improvements in quality of life and suggest a continued survival advantage for ruxolitinib over placebo.
UR - http://www.scopus.com/inward/record.url?scp=84887014885&partnerID=8YFLogxK
U2 - 10.3324/haematol.2013.092155
DO - 10.3324/haematol.2013.092155
M3 - Article
C2 - 24038026
AN - SCOPUS:84887014885
SN - 0390-6078
VL - 98
SP - 1865
EP - 1871
JO - Haematologica
JF - Haematologica
IS - 12
ER -