From the Guidelines
The recommended starting dose of Jakafi (ruxolitinib) for polycythemia vera (PV) is 10 mg taken orally twice daily. This dosage may be adjusted based on patient response and tolerability. For patients with platelet counts between 50,000/mm³ and 100,000/mm³, a reduced starting dose of 5 mg twice daily is recommended [not explicitly stated in the provided evidence, but based on general knowledge of Jakafi dosing]. Dose adjustments can be made in increments of 5 mg twice daily, with a maximum dose of 25 mg twice daily. Regular blood count monitoring is essential during treatment, and dose modifications may be necessary if platelet or neutrophil counts decrease below certain thresholds.
Key Considerations
- Jakafi should be taken with or without food, and missed doses should not be made up (simply continue with the next scheduled dose) 1.
- Jakafi works by inhibiting JAK1 and JAK2 enzymes, which are involved in the signaling of cytokines and growth factors important for blood cell production.
- Treatment is typically continued as long as the patient shows benefit, with regular monitoring for side effects such as anemia, thrombocytopenia, and infections.
Patient Selection
- A cytoreductive drug should be prescribed in high-risk PV patients, i.e. >60 years and/or with a history of a vascular event 1.
- Jakafi can be used to treat aquagenic pruritus, a disabling symptom in some PV patients 1.
Monitoring and Adjustments
- Regular monitoring of blood counts, including platelet and neutrophil counts, is crucial during Jakafi treatment.
- Dose adjustments may be necessary to manage side effects or to optimize treatment response. It is essential to note that while the provided evidence does not explicitly discuss Jakafi dosing, the recommended dosage is based on general knowledge of the medication and its use in treating polycythemia vera.
From the Research
Dose of Jakafi for PV
- The dose of Jakafi (ruxolitinib) for Polycythemia Vera (PV) is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the efficacy and safety of ruxolitinib in treating PV, with dosages implied to be part of the standard treatment protocol.
- In the study by 3, ruxolitinib was shown to be superior to standard therapy in controlling hematocrit, reducing spleen volume, and improving symptoms associated with PV.
- The study by 4 reports on the combination therapy of ruxolitinib and pegylated interferon alfa-2a in newly diagnosed patients with PV, with a focus on safety and efficacy.
- Another study by 5 investigates the combination treatment of ruxolitinib and low-dose pegylated interferon-α2 in patients with PV or myelofibrosis, highlighting the improvement in cell counts, reduction in bone marrow cellularity and fibrosis, and decrease in JAK2 V617F burden.
- A meta-analysis by 6 evaluates the efficacy and safety of ruxolitinib compared to best available therapy in patients with PV, showing higher hematocrit control, treatment response, and improvement in Myeloproliferative Neoplasms-Symptom Assessment Form scores.
Key Findings
- Ruxolitinib has been shown to be effective in treating PV, with improvements in hematocrit control, symptom reduction, and quality of life 3, 4, 5, 6.
- The combination of ruxolitinib with other therapies, such as pegylated interferon alfa-2a, may offer additional benefits in treating PV 4, 5.
- Ruxolitinib is associated with a higher risk of anemia, herpes zoster infections, and nonmelanoma skin cancer compared to best available therapy 6.