Steroid-Refractory aGVHD—Identified As Early As 3 Days After Starting Treatment
For US Healthcare Professionals Only

For your patients with steroid-refractory acute graft-versus-host disease (GVHD)1

Potential for Rapid Disease Progression Makes Early Identification Critical

For your patients with steroid-refractory acute graft-versus-host disease (GVHD)1

Potential for Rapid Disease Progression Makes Early Identification Critical

 

Response to Daily Systemic Steroids

STEROID-REFRACTORY PATIENTS CAN BE IDENTIFIED AS EARLY AS 3 DAYS AFTER STARTING TREATMENT

Additional Therapy May Be Required

Approximately half of patients with acute GVHD (aGVHD) will not achieve an adequate response to steroids.2-6

Image of a chart showing the standard of care for initial aGVHD therapy: Daily systemic steroids
Image of a chart showing the standard of care for initial aGVHD therapy: Daily systemic steroids

Patients Can Be Identified As Early As 3 Days

Patients with steroid-refractory aGVHD can be identified as early as 3 days after starting treatment with steroids.6

Image of a chart showing EBMT-NIH-CIBMTR Task Force Guidance Defines Response to Steroids
Image of a chart showing EBMT-NIH-CIBMTR Task Force Guidance Defines Response to Steroids

CIBMTR, Center for International Blood and Marrow Transplant Research; EBMT, European Society for Blood and Marrow Transplantation; NIH, National Institutes of Health.

Disease Progression in Steroid-Refractory aGHVD: Real-World Data

An Incyte-sponsored retrospective chart review of 168 patients with Grade II to IV Steroid-Refractory aGVHD9*

  • Median time from diagnosis to maximum grade was 6 days in the steroid-refractory population
  • 40% of the 134 patients with Grade II or III steroid-refractory aGVHD advanced to a higher maximum grade
  • 54% of patients with steroid-refractory aGVHD had new organ involvement or an increase in grade
  • Among the 66 patients with steroid-refractory aGVHD in skin alone at diagnosis, 36% developed symptoms in a new organ
Image of a chart showing the progression of aGVHD in a retrospective chart review
Image of a chart showing the progression of aGVHD in a retrospective chart review

*A multicenter, retrospective chart review conducted at 11 large US academic and community transplant centers in patients with Grade II–IV steroid-refractory aGVHD who had their first hematopoietic cell transplantation between January 2014 and June 2016.

Get efficacy results from the REACH1 study with Jakafi.

FDA approval for Jakafi for the treatment of steroid-refractory aGVHD was based on the data from the REACH1 study. REACH2 data are not included in the Jakafi Prescribing Information. Although the adverse event data reported in REACH2 is informative, the risk information as described in the Full Prescribing Information for Jakafi should be considered when making prescribing decisions.

References

  1. Jakafi Prescribing Information. Wilmington, DE: Incyte Corporation.
  2. Dignan FL, Clark A, Amrolia P, et al. Diagnosis and management of acute graft-versus-host disease. Br J Haematol. 2012;158(1):30-45.
  3. Martin PJ, Rizzo JD, Wingard JR, et al. First- and second-line systemic treatment of acute graft-versus-host disease: recommendations of the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2012;18(8):1150-1163.
  4. Hill L, Alousi A, Kebriaei P, et al. New and emerging therapies for acute and chronic graft versus host disease. Ther Adv Hematol. 2018;9(1):21-46.
  5. MacMillan ML, Weisdorf DJ, Wagner JE, et al. Response of 443 patients to steroids as primary therapy for acute graft-versus-host disease: comparison of grading systems. Biol Blood Marrow Transplant. 2002;8(7):387-394.
  6. Schoemans HM, Lee SJ, Ferrara JL, et al. EBMT—NIH—CIBMTR Task Force position statement on standardized terminology & guidance for graft-versus-host disease assessment. Bone Marrow Transplant. 2018;53(11):1401-1415.
  7. Mendoza KA, Chen H, Englehardt BG, et al. Similar outcomes in early failure steroid dependent acute GvHD and upfront steroid refractory acute GvHD. Presented at: 59th American Society of Hematology (ASH) Annual Meeting and Exposition; December 9-12, 2017; Atlanta, GA; Abstract 1975.
  8. Das-Gupta E, Greinix H, Jacobs R, et al. Extracorporeal photopheresis as second-line treatment for acute graft-versus-host disease: impact on six-month freedom from treatment failure. Haematologica. 2014;99(11):1746-1752.
  9. Yu J, Hanna B, Paranagama D, Tang J, Naim A, Galvin JP. Disease progression, hospital readmissions, and clinical outcomes of patients with steroid-refractory acute graft-versus-host disease: a multicenter chart review. Blood. 2019;134(suppl, abstr):1994.
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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-02777  09/21

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-02777  09/21