NEJM: Ruxolitinib significantly reduces risk of acute graft anti-host disease after heterogeneous stem cell transplant

Acute graft anti-host disease (GVHD) is an important complication after allogeneic stem cell transplantation, and not all patients respond to standard treatment of glucocorticoidsIn phase II trials, JAK inhibitor ruxolitinib showed potential efficacy in patients with glucocorticoids in patients with refractory acute GVHDrecently researchers conducted a multicenter, randomized, open-label Phase III trial comparing the efficacy and safety of oral ruxolitinib (10 mg per day) with nine other commonly used treatment sages (contrasts) for patients with glycocorticoid serotic glycogen incursions after transplantation of allogeneic stem cells aged 12 years or olderThe main endpoint of the study was the 28th day of the overall response (full or partial reaction)The key secondary endpoint is the 56th day of the long-lasting overall response309 patients participated in the study, 154 were treated with ruxolitinib and 155 were in the control groupOn the 28th day, the total efficiency of the ruxolitinib group was higher than that of the control group (62% (96) vs39% of the 61; the ratio was 2.64)The response persistence of the ruxolitinib group on the 56th day was higher than that of the control group (40% (61) vs22% (34) and the advantage ratio was 2.38At 6 months, the cumulative treatment response loss rates were 10% and 39%, respectively, in the ruxolitinib group and the control groupCompared to the control group, the survival of no treatment response failure in the ruxolitinib group was significantly longer (5.0 months vs1.0 months; The median total lifetime of the ruxolitinib group was 11.1 months and the control group was 6.5 months (the risk of death ratio was 0.83)As of the 28th day, the most common adverse events were platelet reduction (ruxolitinib group 50/152 vs control group 27/150), anemia (46 and 42) and cytomegalovirus infection (39 and 31 cases)Ruxolitinib treatment can significantly reduce the risk of acute graft anti-host disease after heterogeneous stem cell transplantation