Dosing for Jakafi in Acute GVHD | Jakafi HCP
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For steroid-refractory acute graft-versus-host disease (aGVHD) in adult and pediatric patients 12 years of age and older

Individualized Dosing
for Jakafi in aGVHD

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For steroid-refractory acute graft-versus-host disease (aGVHD) in adult and pediatric patients 12 years of age and older

Individualized Dosing
for Jakafi in aGVHD

 

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View the GVHD Dual Indication Dosing Guide

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View the GVHD Dual Indication Dosing Guide

Getting Started With Jakafi in aGVHD

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START with the appropriate dose1

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START with the appropriate dose1

Evaluate blood parameters before and during treatment with Jakafi.

Jakafi 5mg aGVHD
Dosing 5mg Jakafi

Consider increasing dose to 10 mg twice daily after ≥3 days of treatment if absolute neutrophil count (ANC) and platelet (PLT) counts are not decreased by 50% or more relative to the first day of dosing.

In Reach1, starting dose
In Reach1, starting dose mobile
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MONITOR: Monitoring patients after initiation of Jakafi is essential1

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MONITOR: Monitoring patients after initiation of Jakafi is essential1

Dose reductions should be considered for PLT counts, ANCs, or bilirubin elevation as described below (see Jakafi Dose Modifications below) and in the Full Prescribing Information.

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OPTIMIZE: Individualize dosing of Jakafi to optimize the balance between safety and efficacy1

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OPTIMIZE: Individualize dosing of Jakafi to optimize the balance between safety and efficacy1

Doses may be modified based on safety and efficacy; doses of 5 mg once daily to 10 mg twice daily may be given.

  • Dose reductions may be used to manage side effects:
    • 10 mg twice daily may be reduced to 5 mg twice daily
    • 5 mg twice daily may be reduced to 5 mg once daily
  • Patients who are unable to tolerate Jakafi at 5 mg once daily should have treatment interrupted until their clinical and/or laboratory parameters recover
  • Tapering may be considered after 6 months of treatment as clinically indicated in patients who have discontinued therapeutic doses of steroids
    • Taper Jakafi by 1 dose level approximately every 8 weeks (10 mg twice daily to 5 mg twice daily to 5 mg once daily)
    • If aGVHD signs or symptoms recur during or after the taper of Jakafi, consider retreatment

Jakafi Dose Modifications

View the dosing modifications for patients with cytopenias, elevated total bilirubin (with or without liver GVHD), hepatic or renal impairment, and when used with strong CYP3A4 inhibitors/inducers or fluconazole.

CYTOPENIAS
ELEVATED TOTAL BILIRUBIN
HEPATIC OR RENAL IMPAIRMENT
USE WITH STRONG CYP3A4 INHIBITORS/INDUCERS
OR FLUCONAZOLE

Learn about the mechanism of action.

References

  1. Jakafi Prescribing Information. Wilmington, DE: Incyte Corporation.
  2. Data on file. Incyte Corporation. Wilmington, DE.

Indications and Usage

Jakafi is indicated for treatment of polycythemia vera (PV) in adults who have had an inadequate response to or are intolerant of hydroxyurea.

Jakafi is indicated for treatment of intermediate or high-risk myelofibrosis (MF), including primary MF, post-polycythemia vera MF and post-essential thrombocythemia MF in adults.

Jakafi is indicated for treatment of steroid-refractory acute graft-versus-host disease (aGVHD) in adult and pediatric patients 12 years and older.

Jakafi is indicated for treatment of chronic graft-versus-host disease (cGVHD) after failure of one or two lines of systemic therapy in adult and pediatric patients 12 years and older.

Important Safety Information

  • Treatment with Jakafi® (ruxolitinib) can cause thrombocytopenia, anemia and neutropenia, which are each dose-related effects. Perform a pre-treatment complete blood count (CBC) and monitor CBCs every 2 to 4 weeks until doses are stabilized, and then as clinically indicated
  • Manage thrombocytopenia by reducing the dose or temporarily interrupting Jakafi. Platelet transfusions may be necessary
  • Patients developing anemia may require blood transfusions and/or dose modifications of Jakafi
  • Severe neutropenia (ANC <0.5 × 109/L) was generally reversible by withholding Jakafi until recovery
  • Serious bacterial, mycobacterial, fungal and viral infections have occurred. Delay starting Jakafi until active serious infections have resolved. Observe patients receiving Jakafi for signs and symptoms of infection and manage promptly. Use active surveillance and prophylactic antibiotics according to clinical guidelines
  • Tuberculosis (TB) infection has been reported. Observe patients taking Jakafi for signs and symptoms of active TB and manage promptly. Prior to initiating Jakafi, evaluate patients for TB risk factors and test those at higher risk for latent infection. Consult a physician with expertise in the treatment of TB before starting Jakafi in patients with evidence of active or latent TB. Continuation of Jakafi during treatment of active TB should be based on the overall risk-benefit determination
  • Progressive multifocal leukoencephalopathy (PML) has occurred with Jakafi treatment. If PML is suspected, stop Jakafi and evaluate
  • Advise patients about early signs and symptoms of herpes zoster and to seek early treatment
  • Increases in hepatitis B viral load with or without associated elevations in alanine aminotransferase and aspartate aminotransferase have been reported in patients with chronic hepatitis B virus (HBV) infections. Monitor and treat patients with chronic HBV infection according to clinical guidelines
  • When discontinuing Jakafi, myeloproliferative neoplasm-related symptoms may return within one week. After discontinuation, some patients with myelofibrosis have experienced fever, respiratory distress, hypotension, DIC, or multi-organ failure. If any of these occur after discontinuation or while tapering Jakafi, evaluate and treat any intercurrent illness and consider restarting or increasing the dose of Jakafi. Instruct patients not to interrupt or discontinue Jakafi without consulting their physician. When discontinuing or interrupting Jakafi for reasons other than thrombocytopenia or neutropenia, consider gradual tapering rather than abrupt discontinuation
  • Non-melanoma skin cancers (NMSC) including basal cell, squamous cell, and Merkel cell carcinoma have occurred. Perform periodic skin examinations
  • Treatment with Jakafi has been associated with increases in total cholesterol, low-density lipoprotein cholesterol, and triglycerides. Assess lipid parameters 8-12 weeks after initiating Jakafi. Monitor and treat according to clinical guidelines for the management of hyperlipidemia
  • Another JAK-inhibitor has increased the risk of major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, and stroke (compared to those treated with tumor TNF blockers) in patients with rheumatoid arthritis, a condition for which Jakafi is not indicated. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with Jakafi particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur
  • Another JAK-inhibitor has increased the risk of thrombosis, including deep venous thrombosis (DVT), pulmonary embolism (PE), and arterial thrombosis (compared to those treated with TNF blockers) in patients with rheumatoid arthritis, a condition for which Jakafi is not indicated. In patients with myelofibrosis (MF) and polycythemia vera (PV) treated with Jakafi in clinical trials, the rates of thromboembolic events were similar in Jakafi and control treated patients. Patients with symptoms of thrombosis should be promptly evaluated and treated appropriately
  • Another JAK-inhibitor has increased the risk of lymphoma and other malignancies excluding NMSC (compared to those treated with TNF blockers) in patients with rheumatoid arthritis, a condition for which Jakafi is not indicated. Patients who are current or past smokers are at additional increased risk. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with Jakafi, particularly in patients with a known secondary malignancy (other than a successfully treated NMSC), patients who develop a malignancy, and patients who are current or past smokers
  • In myelofibrosis and polycythemia vera, the most common nonhematologic adverse reactions (incidence ≥15%) were bruising, dizziness, headache, and diarrhea. In acute graft-versus-host disease, the most common nonhematologic adverse reactions (incidence >50%) were infections (pathogen not specified) and edema. In chronic graft-versus-host disease, the most common nonhematologic adverse reactions (incidence ≥20%) were infections (pathogen not specified) and viral infections
  • Avoid concomitant use with fluconazole doses greater than 200 mg. Dose modifications may be required when administering Jakafi with fluconazole doses of 200 mg or less, or with strong CYP3A4 inhibitors, or in patients with renal or hepatic impairment. Patients should be closely monitored and the dose titrated based on safety and efficacy
  • Use of Jakafi during pregnancy is not recommended and should only be used if the potential benefit justifies the potential risk to the fetus. Women taking Jakafi should not breastfeed during treatment and for 2 weeks after the final dose

Please see Full Prescribing Information for Jakafi.

Jakafi and the Jakafi logo are registered trademarks of Incyte. All other trademarks are the property of their respective owners.
© 2014-2021, Incyte Corporation. MAT-JAK-03008  10/21

Jakafi and the Jakafi logo are registered trademarks of Incyte. All other trademarks are the property of their respective owners.
© 2014-2021, Incyte Corporation. MAT-JAK-03008  10/21