Optimizing management of ruxolitinib in patients with myelofibrosis: the need for individualized dosing

Table 1 Ruxolitinib dose modifications recommended for MF patients with starting platelet count of at least 100 × 10 ⁹ /L*

	Dose at time of decline in platelet count					Maximum dose based on platelet count after prior treatment interruption or dose reduction
	25 mg BID	20 mg BID	15 mg BID	10 mg BID	5 mg BID
Current platelet count	New dose to be used
≥125 × 10⁹/L	No change	No change	No change	No change	No change	20 mg BID
100 to <125 × 10⁹/L	20 mg BID	15 mg BID	No change	No change	No change	15 mg BID
75 to <100 × 10⁹/L	10 mg BID	10 mg BID	10 mg BID	No change	No change	10 mg BID for 2 weeks; if stable, may increase to 15 mg BID
50 to <75 × 10⁹/L	5 mg BID	5 mg BID	5 mg BID	5 mg BID	No change	5 mg BID for 2 weeks; if stable, may increase to 10 mg BID
<50 × 10⁹/L	Hold	Hold	Hold	Hold	Hold	Continue holding

*Starting ruxolitinib doses of 15 mg BID for patients with platelet counts of 100 to 200 × 10⁹/L and 20 mg BID for those with a platelet count >200 × 10⁹/L. Recommended dose modifications based on US prescribing information.
For insufficient response, doses may be increased in 5-mg BID increments to a maximum of 25 mg BID, provided that platelet and neutrophil counts are adequate.
BID, twice daily; MF, myelofibrosis.
Data from Jakafi prescribing information (Incyte Corporation, June 2013).
See full prescribing information for a complete description of FDA-approved dosing of ruxolitinib in patients with intermediate or high-risk MF.

ISSN: 1756-8722