Drug updated on 4/18/2024
| Dosage Form | Capsule (oral; 100 mg) |
| Drug Class | Kinase inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of adults with intermediate or high-risk primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis with a platelet count below 50 × (10)^9/L.
Summary
- Pacritinib citrate (Vonjo) is indicated for the treatment of adults with intermediate or high-risk primary or secondary myelofibrosis, particularly those with a platelet count below 50 × (10)^9/L. It is noted for its suitability as a second-line treatment after ruxolitinib, implying effectiveness in patients who have already been treated with this drug.
- The study involved a systematic review and meta-analysis that evaluated four Janus kinase inhibitors, including pacritinib citrate for treating myelofibrosis. This study involved research on 1953 patients randomized to receive either ruxolitinib, fedratinib, pacritinib citrate, momelotinib, or control treatments.
- Ruxolitinib appears slightly more effective than pacritinib citrate in reducing spleen size as first-line therapy. However, the advantage of Vonjo might lie in its efficacy among patients previously exposed to ruxolitinib, suggesting usefulness in sequential treatment strategies.
- Compared to other JAK inhibitors like fedratinib and ruxolitinib, which are FDA approved for treating myelofibrosis, Vonjo may not be the first choice due to less effectiveness on spleen volume reduction. However, it opens up a valuable therapeutic window, especially when considering patient subgroup considerations, such as prior exposure to JAK inhibitor drugs.
- Momelotinib and fedratinib are introduced as comparable alternatives, having similar efficacy levels but exhibiting lesser toxicity towards erythrocytes and platelets, respectively. This suggests their preference based on side effect profiles, specific impact on anemia, and thrombopenia conditions compared against Vonjo.
- Pacritinib citrate's role is highlighted specifically among those who haven't achieved desired outcomes using ruxolitinib, thus recognizing this drug's place within the overall treatment algorithm becomes crucial while decisions on its use need further research delineating its safety and effectiveness alongside patient subgroup considerations.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Vonjo (pacritinib) prescribing information. | 2023 | CTI BioPharma Corp., Seattle WA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Efficacy and tolerability of Janus kinase inhibitors in myelofibrosis: a systematic review and network meta-analysis. | 2021 | Blood Cancer Journal |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Myeloproliferative Neoplasms, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. | 2022 | National Comprehensive Cancer Network |