Ojjaara May Improve Anemia and Reduce Transfusions in Myelofibrosis

The significant burden of anemia for patients with myelofibrosis and the potential benefit of Ojjaara(momelotinib) in this setting was discussed by Dr. Francesca Palandri, study author of the phase 3 SIMPLIFY-1 trial and a medical doctor at the University of Bologna in Italy.

In the phase 3 SIMPLIFY-1 trial, Ojjaara was shown to be as effective as Jakafi (ruxolitinib) at reducing spleen size, but more effective in helping patients with anemia achieve transfusion independence. By week 24, 67% of patients taking Ojjaara were transfusion independent, compared with 49% of those on Jakafi. Transfusion independence was defined as avoiding transfusions and maintaining hemoglobin levels above 8 g/dL for at least 12 weeks.

Palandri emphasized that anemia is common in patients who have myelofibrosis. Around 40% of patients have low hemoglobin at diagnosis, which rises to 60% within a year, and transfusion needs nearly double during that time. Anemia not only shortens survival but also worsens quality of life and increases fatigue, as well as causes social withdrawal and caregiver burden.

She noted that transfusion dependency significantly increases hospital time and costs and also affects work and daily functioning. In her team’s recent analysis in Italy, transfusion-dependent patients spent six times more time in hospitals and incurred 40 times higher direct healthcare costs than those without anemia. Indirect costs like lost productivity were also six times greater.

Because Ojjaara was the only agent in the study to consistently improve both spleen size and anemia, Palandri said these results support making transfusion independence a central treatment goal, particularly for patients with low hemoglobin and lower platelet counts.

Transcript

Can you explain why improving anemia is important for overall survival and quality of life?

Unfortunately, anemia is one of the main features of myelofibrosis. We know that around 40% of patients will present with hemoglobin less than 10 grams per deciliter at diagnosis, and that percentage increases to around 60% after one year. We also know that about one-quarter of patients require transfusions at diagnosis, and that number nearly doubles within the first year.

Any degree of anemia correlates with decreased survival — patients with severe anemia have a median survival that’s four times shorter than those with no anemia at all. That’s why low hemoglobin is a key factor included in all current prognostic scoring systems for myelofibrosis.

But anemia isn’t only about survival or the risk of transformation to leukemia. It also significantly impacts quality of life. Many patients find transfusions to be very burdensome. Transfusion dependency correlates with a worse quality of life and a greater symptom burden, especially fatigue, which is linked to reduced productivity and social engagement.

For example, in Italy, we recently evaluated both the economic and organizational burden of anemia in myelofibrosis. We found that patients who require transfusions spend six times more time in hospitals than patients without anemia. There were also 40 times higher direct healthcare costs for the National Health System. We looked at indirect costs too — including lost productivity for both patients and caregivers — and found they were six times higher in transfusion-dependent patients.

We also asked patients about their perception of anemia, and they reported a significant disruption across all aspects of their lives, including social, work and daily activities. So overall, anemia is a major burden — for the healthcare system, for caregivers, and most importantly, for patients. It’s also a strong indicator of poor prognosis.

Transcript has been edited for clarity and conciseness

Reference

“Impact of dual spleen response and transfusion independence on survival in JAK inhibitor-naive patients with myelofibrosis and anemia treated with momelotinib: a subgroup analysis of SIMPLIFY-1,”by Dr. Francesca Palandri, et al., EHA Library.

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