Momelotinib Impacts Treatment Methods for Anemia in Myelofibrosis


Results of the phase 3 MOMENTUM study showed that the JAK1/JAK2 inhibitor momelotinib can provide treatment for the patient’s disease and also their anemia.

Aaron T. Gerds, MD, MS, assistant professor in medicine (Hematology and Medical Oncology) at the Cleveland Clinic, discusses how the results of the phase 3 MOMENTUM trial (NCT04173494) have shifted thinking toward the use of momelotinib for patients with myelofibrosis.

The JAK1/JAK2 inhibitor was compared with danazol in patients who had received prior JAK inhibitor therapy and were anemic. The results showed that patients with myelofibrosis given momelotinib had better control of their anemia, but also demonstrated spleen shrinkage and relief of some symptoms. According to Gerds, this shows that momelotinib can tackle 2 issues at once with patients by treating patients’ disease and also treating their anemia. Importantly, the drug has also proven its safety in comparison to danazol and also showed a durable response.


0:08 | Well, there's so much to unpack from the MOMENTUM study, a prospective randomized trial in patients with myelofibrosis pitting momelotinib vs danazol. Danazol was picked because it is an active drug that improves anemia in patients with myelofibrosis. So, clearly the first thing you go to is [compare] the anemia responses and clearly momelotinib can improve anemia in patients with myelofibrosis. But the other points are it can shrink spleens and it can improve symptoms, so if you think about it, from a certain perspective, it's like one-stop shopping. You get your JAK inhibitor plus your anemia drug all in one pill. To me, that is the major take home point of the MOMENTUM studies, that momelotinib can prove to be a very helpful therapy in the treatment of [patients with] myelofibrosis.

0:51 | Of course, as a clinical researcher, I had my eye on momelotinib as being the new backbone for a lot of our trials going forward in combination therapy, because it doesn't have the myelosuppressive effects of ruxolitinib [Jakafi] and still can treat the spleen and symptoms associated with myelofibrosis. There are some subtle things within the study I think are incredibly important. The one thing I like to point out is the fact that the rates of neuropathy were not high. That was an early concern during the development of momelotinib, that it might lead to neuropathies. But there were no differences between momelotinib and danazol on the MOMENTUM study in terms of the rates of neuropathy. So, I think that's really a key point is not only the efficacy, but really the safety of momelotinib.

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