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INGRAIN-MF
Incorporating genetics, risk and associated burden into MF management

MODULE 4: Optimising management of myelofibrosis and evaluating the use of JAK inhibitors

Having completed this module, you should now have a better appreciation of:

  • different treatment options for patients with myelofibrosis (MF)
  • the efficacy of the JAK1/2 inhibitor ruxolitinib for controlling MF-related splenomegaly and symptoms3
  • the practicalities and considerations for use of ruxolitinib

Retest your knowledge below.

Post-module multiple-choice questions

When your answers have been submitted, you will be able to review the correct answers and receive your final score.

Correct answer is highlighted.

Answer: In one of the largest studies of alloSCT in MF, mortality related to treatment was 35% for matched related transplants and 50% for unrelated transplants.1

Correct answer is highlighted.

Answer: Hydroxyurea is effective in reducing spleen size; response lasts on average 1 year.1

Correct answer is highlighted.

Answer: The mean decrease in spleen length from baseline was 56% in patients receiving ruxolitinib (n=146), compared with an increase of 4% in patients receiving best available therapy (n=73).2

Correct answer is highlighted.

Answer: There were significantly fewer treatment-related events of anaemia in patients in the momelotinib group compared with ruxolitinib, occurring in 13.6% of patients on momelotinib (n=29/214) versus 38.0% (n=82/216).3 BSH guidelines suggest momelotinib as an option for the treatment of MF‑related splenomegaly or symptoms, particularly for those with MF and anaemia.4

Correct answer is highlighted.

Answer: The most frequently reported adverse events related to ruxolitinib usage in MF are anaemia (84% of patients) and thrombocytopenia (81%). Bruising, dizziness and neutropenia are reported in 33%, 22% and 21% of patients, respectively.5

JAK: Janus kinase

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Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.
Adverse events should also be reported to Novartis online through the pharmacovigilance intake (PVI) tool at www.novartis.com/report or alternatively email medinfo.uk@novartis.com or call 01276 698370

References
  1. Tefferi A. Primary myelofibrosis: 2021 update on diagnosis, risk-stratification and management. Am J Hematol 2021;96:145-162
  2. Harrison C, Kiladjian J J et al. JAK inhibition with ruxolitinib versus best available therapy for myelofibrosis. N Engl J Med 2012;366:787-798
  3. Mesa R A, Kiladjian J J et al. SIMPLIFY-1: a phase III randomized trial of momelotinib versus ruxolitinib in janus kinase inhibitor-naive patients with myelofibrosis. J Clin Oncol 2017;35:3844-3850
  4. McLornan D P, Psaila B et al. The management of myelofibrosis: A British Society for Haematology Guideline. Br J Haematol 2024;204:136-150
  5. Ruxolitinib Summary of Product Characteristics. Available at: medicines.org.uk