Publication details

Utilization of healthcare services in acute myocardial infarction and the risk of out-of-hospital cardiac death

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Authors

MOTOVSKA Zuzana HLINOMAZ Ota HROMADKA Milan MROZEK Jan PRECEK Jan KALA Petr MUZAFAROVA Tamilla KETTNER Jiri MATEJKA Jan BIS Josef CERVINKA Pavel TOMASOV Pavol KLECHOVA Anna ŠANCA Ondřej JARKOVSKÝ Jiří

Year of publication 2024
Type Article in Periodical
Magazine / Source Panminerva medica
MU Faculty or unit

Faculty of Medicine

Citation
web https://www.minervamedica.it/en/journals/panminerva-medica/article.php?cod=R41Y9999N00A23080302
Doi http://dx.doi.org/10.23736/S0031-0808.23.04910-8
Keywords bone marrow fibrosis; momelotinib; ruxolitinib
Attached files
Description Bone marrow fibrosis (BMF) is a pathological feature of myelofibrosis, with higher grades associated with poor prognosis. Limited data exist on the association between outcomes and BMF changes. We present BMF data from Janus kinase (JAK) inhibitor–naive patients from SIMPLIFY-1 (NCT01969838), a double-blind, randomized, phase 3 study of momelotinib vs ruxolitinib. Baseline and week 24 bone marrow biopsies were graded from 0 to 3 as per World Health Organization criteria. Other assessments included Total Symptom Score, spleen volume, transfusion independence status, and hemoglobin levels. Paired samples were available from 144 and 160 patients randomized to momelotinib and ruxolitinib. With momelotinib and ruxolitinib, transfusion independence was achieved by 87% and 44% of patients with BMF improvement of ?1 grade and 76% and 56% of those with stable/worsening BMF; there was no association between BMF changes and transfusion independence for either arm (momelotinib, p = .350; ruxolitinib, p = .096). Regardless of BMF changes, hemoglobin levels also generally increased on momelotinib but decreased on ruxolitinib. In addition, no associations between BMF changes and spleen (momelotinib, p = .126; ruxolitinib, p = .407)/symptom (momelotinib, p = .617; ruxolitinib, p = .833) outcomes were noted, and no improvement in overall survival was observed with ?1-grade BMF improvement (momelotinib, p = .395; ruxolitinib, p = .407). These data suggest that the anemia benefit of momelotinib is not linked to BMF changes, and question the use of BMF assessment as a surrogate marker for clinical benefit with JAK inhibitors.
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