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Comparative Study
. 2025 Jul;21(16):2067-2075.
doi: 10.1080/14796694.2025.2511562. Epub 2025 Jun 6.

Indirect treatment comparisons of momelotinib vs pacritinib safety and anemia outcomes in patients with myelofibrosis

Lucia Masarova  1 , Srdan Verstovsek  1 , Francesca Palandri  2 , Ruben Mesa  3 , Claire Harrison  4 , Balázs Dobi  5 , Boris Gorsh  6 , Zhaohui Wang  6 , Catherine Ellis  6 , Dwaipayan Patnaik  7 , Tom Liu  6 , Venediktos Kapetanakis  8
Affiliations
Comparative Study

Indirect treatment comparisons of momelotinib vs pacritinib safety and anemia outcomes in patients with myelofibrosis

Lucia Masarova et al. Future Oncol. 2025 Jul.

Abstract

Aim: To perform an indirect treatment comparison of safety and anemia outcomes between the Janus kinase (JAK) inhibitors momelotinib and pacritinib in patients with myelofibrosis.

Methods: Treatment-emergent adverse events (AEs) and anemia outcomes were compared in a pooled population of JAK inhibitor - experienced and - naive patients treated with momelotinib (SIMPLIFY-1/SIMPLIFY-2/MOMENTUM) or pacritinib (PERSIST-2/PAC203).

Results: Momelotinib had statistically significantly lower odds and risk for all grades of diarrhea, nausea, peripheral edema, and vomiting as well as grade 3/4 and serious AEs vs pacritinib. Momelotinib-treated patients also had greater odds/possibility of hemoglobin improvement of ≥ 1 g/dL and clinical improvement in hemoglobin.

Conclusions: Momelotinib provides a more favorable safety profile and a higher chance for hemoglobin improvement vs pacritinib.

Keywords: JAK inhibitor; Myelofibrosis; indirect treatment comparison; momelotinib; pacritinib; safety.

Plain language summary

What is this article about?Myelofibrosis is a rare blood cancer that causes abnormal blood cell production. A class of medications known as Janus kinase (JAK) inhibitors can help treat symptoms, which include feeling tired and weak from too few red blood cells, as well as enlarged spleen. So far, four JAK inhibitors have been approved by the US FDA for treating myelofibrosis: ruxolitinib, fedratinib, pacritinib, and momelotinib. However, these JAK inhibitors have different side effects, and clinical trials that directly compare these medications are not always available. We used a method known as indirect comparison to further understand differences in the side effects between momelotinib and pacritinib.What were the results?The findings show that momelotinib was associated with a lower risk of some side effects, including anemia, diarrhea, nausea, swelling from fluid buildup, and vomiting. The study also showed that momelotinib is more likely to increase the amount of hemoglobin, which is a measure of anemia improvement, compared with pacritinib.What do the results of the study mean?These results suggest that momelotinib may be a treatment option with fewer unwanted side effects for people with myelofibrosis.

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Conflict of interest statement

Lucia Masarova reports advisory board participation with MorphoSys. Srdan Verstovsek reports consultancy fees from GSK. Francesca Palandri reports consultancy fees from AOP, Celgene, and Novartis and honoraria from AOP, Celgene, CTI, Novartis, and Sierra Oncology. Ruben Mesa reports honoraria/consultancy fees from AbbVie, BMS, Blueprint, CTI, Genentech, Geron, GSK, Incyte, MorphoSys, Novartis, Sierra Oncology, Sierra, and Telios. Claire Harrison reports consultancy fees from DISC, Galecto, and Keros; honoraria from BMS, CTI, GSK, Novartis, and Sierra; advisory/safety board participation for AOP, Keros, Sumitomo, and Telios; and leadership/fiduciary roles for EHA, MPN Voice, and HemaSphere. Balázs Dobi and Venediktos Kapetanakis are employees of Evidera, which was hired by the sponsor, GSK, to conduct this research. Boris Gorsh is a former employee and shareholder of GSK. Zhaohui Wang, Catherine Ellis, Dwaipayan Patnaik, and Tom Liu are current employees of and may hold stock/stock options with GSK. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing support for this manuscript was provided by Keng Jin Lee, PhD (Nucleus Global, an Inizio Company), based on the authors’ input and in accordance with ICMJE and GPP3 guidelines, and was supported by GSK.

Figures

Figure 1.
Figure 1.
ORs for safety outcomes.
Figure 2.
Figure 2.
RDs for safety outcomes.
Figure 3.
Figure 3.
ORs for anemia outcomes.
Figure 4.
Figure 4.
RDs for anemia outcomes.
See this image and copyright information in PMC

References

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    2. • This phase 3 study found that pacritinib was more effective than BAT for reducing splenomegaly and symptoms in patients with myelofibrosis and thrombocytopenia, including patients who were JAK inhibitor experienced.

    1. Arslan Davulcu E, Oğuz MB, Kılıç E, et al. Treatment of anemia in myelofibrosis: focusing on novel therapeutic options. Expert Opin Investig Drugs. 2024. Jan;33(1):27–37. doi: 10.1080/13543784.2023.2294324 - DOI - PubMed

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