Evaluation of Ruxolitinib versus Best Available Therapy in Treating Primary Myelofibrosis

Objectives: This study aimed to evaluate the effectiveness of ruxolitinib and compare it with the best available therapy in patients with primary myelofibrosis. Ruxolitinib is a Janus kinase inhibitor that is approved for the treatment of myelofibrosis. The therapeutic protocol has changed after the introduction of ruxolitinib. Methods: In this retrospective study, 72 patients with primary myelofibrosis were scrutinised from January 2012 to January 2018 at Nanakali Hemato-Oncology Teaching Centre in Erbil, Iraqi Kurdistan. The patients were divided into two cohorts: 26 of them were treated with ruxolitinib and 46 received the best available therapy. The patients’ characteristics, their response to the treatment and the outcomes were evaluated. The efficacy of the treatment in both groups was compared. Results: Most patients (n = 46; 63.9%) were in the high and intermediate-2 risk groups according to the international prognostic scoring system. At the time of diagnosis, no noticeable differences in the clinical characteristics and laboratory data were observed among the ruxolitinib and best available treatment groups. Ruxolitinib was found to be effective in reducing the size of the spleen and improving the overall survival rate when compared to the best available treatment group (P <0.001 and P = 0.008, respectively). The patients’ performance status had a significant effect on the overall survival in both treatment groups (P = 0.003). Conclusion: Ruxolitinib appears to have a significant role in reducing the spleen size and potentially affect the survival outcomes in patients with myelofibrosis. Keywords: Ruxolitinib; Myelofibrosis; Splenomegaly; Janus Kinase Inhibitor; Iraq.