Does Jakafi (Ruxolitinib) cause elevated Liver Function Tests (LFTs)?

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Last updated: March 18, 2025View editorial policy

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From the Guidelines

Yes, Jakafi (Ruxolitinib) can cause elevated Liver Function Tests (LFTs). This is based on the most recent evidence from 2024, which suggests that treatment with a JAKi, such as Jakafi, can be associated with increased serum levels of liver enzymes 1. Patients taking Jakafi should have their liver function monitored regularly, especially during the first few months of treatment.

Key Considerations

  • The elevations in LFTs are typically mild to moderate and often transient.
  • Patients with pre-existing liver disease, particularly those with severe hepatic disease (Child–Pugh C), should be carefully selected for JAKi treatment and monitored closely 1.
  • Routine laboratory testing, including liver enzymes, is recommended before starting JAKi and during treatment 1.
  • The mechanism behind these elevations likely relates to Jakafi's inhibition of JAK1/2 signaling pathways, which play roles in liver metabolism and immune function.
  • Severe hepatotoxicity is uncommon with Jakafi, but any persistent or significant LFT elevations should prompt medical evaluation.

Monitoring and Management

  • Patients taking Jakafi should have their liver function monitored regularly.
  • If significant LFT elevations occur, dose modification or temporary interruption may be necessary.
  • Patients with pre-existing liver disease may be at higher risk for LFT abnormalities and should be monitored more closely.

From the Research

Jakafi (Ruxolitinib) and Liver Function Tests (LFTs)

  • The provided studies do not directly address the question of whether Jakafi (Ruxolitinib) causes elevated Liver Function Tests (LFTs) in humans 2, 3, 4.
  • However, one study suggests that ruxolitinib may have hepatoprotective effects, as it was shown to alleviate carbon tetrachloride-induced hepatotoxicity in mice via multiple mechanisms, including reducing inflammation and oxidative stress 5.
  • Another study discusses the use of ruxolitinib in myelofibrosis, but does not mention its effects on LFTs 6.
  • There is no direct evidence in the provided studies to suggest that Jakafi (Ruxolitinib) causes elevated LFTs, but more research may be needed to fully understand its effects on liver function.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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