From the Research
Fedratinib should be temporarily discontinued in patients with serious or active infections until the infection resolves, as recommended by the most recent and highest quality study 1. When considering the indications for discontinuing Fedratinib in patients with infections, it is crucial to prioritize the patient's morbidity, mortality, and quality of life. The decision to discontinue Fedratinib should be based on the severity of the infection and the patient's overall clinical status.
Key Considerations
- For mild to moderate infections, clinical judgment is needed to determine if treatment can continue with close monitoring.
- When discontinuing Fedratinib due to infection, monitor patients for return of myelofibrosis symptoms, as these may reappear within one week of stopping the medication.
- Upon resolution of the infection, Fedratinib can typically be restarted at the previous effective dose.
- The recommendation to discontinue Fedratinib during serious infections stems from its mechanism as a JAK2 inhibitor, which suppresses immune function by inhibiting cytokine signaling and potentially impairing the body's ability to fight infections, as noted in 2 and 1.
Management of Infections
- During the treatment interruption, supportive care may be needed to manage returning disease symptoms.
- Before restarting Fedratinib, ensure complete resolution of the infection and reassess the patient's overall clinical status to determine if any dose adjustments are necessary, as suggested by 3 and 1.
- It is essential to balance the benefits of Fedratinib treatment with the potential risks of infection, considering the patient's individual circumstances and the severity of their myelofibrosis, as discussed in 4 and 5.