Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
Salzburg Cancer Research Institute, Paracelsus Medical University Salzburg, Cancer Cluster Salzburg, Salzburg, Austria.
Br J Haematol. 2020 Dec;191(5):764-774. doi: 10.1111/bjh.16729. Epub 2020 Jun 24.
Primary objective of this non-interventional, post-authorisation safety study was to provide real-world safety data [incidence of adverse drug reactions (ADRs)/serious adverse events (SAEs)] on adult patients with myelofibrosis exposed/or not exposed to ruxolitinib. Key secondary objectives included the incidence/outcome of events of special interest (bleeding events, serious/opportunistic infections, second primary malignancies, and deaths). Overall, 462 patients were included [prevalent users = 260, new users = 32, non-exposed = 170 (inclusive of ruxolitinib-switch, n = 57)]. The exposure-adjusted incidence rates (per 100 patient-years) of ADRs (19·3 vs. 19·6) and SAEs (25·2 vs. 25·0) were comparable amongst new-users versus prevalent-users cohorts, respectively; most frequent ADRs across all cohorts included thrombocytopenia, anaemia, epistaxis, urinary tract infection, and herpes zoster. Anaemia, pneumonia, general physical health deterioration, sepsis, and death were the most frequent SAEs across all cohorts. Incidence rates of bleeding events (21·6) and serious/opportunistic infections (34·5) were higher in ruxolitinib-switch cohort versus other cohorts. The incidence rate of second primary malignancies was higher in the prevalent-users cohort (10·1) versus other cohorts. The observed safety profile of ruxolitinib in the present study along with the safety findings from the COMFORT/JUMP/EXPAND studies support the use of ruxolitinib for long-term treatment of patients with myelofibrosis.
本非干预性、上市后安全性研究的主要目的是提供接受或未接受鲁索利替尼治疗的成人骨髓纤维化患者的真实世界安全性数据(不良反应[ADR] /严重不良事件[SAE]的发生率)。主要次要目标包括特殊关注事件(出血事件、严重/机会性感染、第二原发恶性肿瘤和死亡)的发生率/结局。共有 462 名患者纳入研究[现用患者=260 名,新用患者=32 名,未用患者=170 名(包括鲁索利替尼转换患者,n=57)]。新用患者和现用患者队列的 ADR(19.3 比 19.6)和 SAE(25.2 比 25.0)发生率经暴露调整后相似;所有队列中最常见的 ADR 包括血小板减少症、贫血、鼻出血、尿路感染和带状疱疹。所有队列中最常见的 SAE 包括贫血、肺炎、一般健康状况恶化、脓毒症和死亡。与其他队列相比,鲁索利替尼转换队列的出血事件(21.6)和严重/机会性感染(34.5)发生率更高。现用患者队列的第二原发恶性肿瘤发生率(10.1)高于其他队列。本研究中观察到的鲁索利替尼安全性概况以及 COMFORT/JUMP/EXPAND 研究的安全性发现支持将鲁索利替尼用于骨髓纤维化患者的长期治疗。