Treatment persistence and overall survival in myelofibrosis treated with ruxolitinib were not affected by the covid-19 pandemic, despite the reduced starting dose: Analysis of AIFA registries

TL;DR

The study found that the COVID-19 pandemic did not impact treatment persistence or survival in myelofibrosis patients taking ruxolitinib, even with a lower starting dose.

Contribution

This is the first study to show that the pandemic did not negatively affect treatment outcomes for myelofibrosis patients on ruxolitinib.

Findings

Patients treated after the pandemic had similar overall survival compared to those treated before.

The likelihood of stopping treatment was not significantly different between the two groups.

Despite a reduced starting dose post-pandemic, treatment persistence remained unaffected.

Abstract

We analyzed the outcome of 2229 patients with myelofibrosis (MF) treated with ruxolitinib before and after the COVID-19 pandemic. Two populations of MF were defined from the AIFA web monitoring registries: the pre-COVID-19 (1703, 76.4%) and the post-COVID-19 (526, 23.6%) cohorts. The two populations were balanced using the Inversity Probability of Treatment Weighting. The median age was 69 years and 73 years in the pre- and post- COVID-19 era, respectively. There were no differences in spleen diameters at baseline prior to ruxolitinib in the two groups, but a difference in median spleen volume was noted (961 cm3 in the pre-era and 788.3 cm3 in the post-era). Overall, intermediate-2 IPSS risk were 67.2% in the pre- and 72% in the post-era, whereas the high-risk category was 32.7% and 27.9%, respectively. More patients started on a reduced dose in the post-COVID-19 era (73.5% versus 65% in the pre-era). After adjusting for the differences, an analysis of overall survival revealed no differences between the two groups (HR 0.875, p > 0.05). Patients who started ruxolitinib after COVID-19 had similar probability to stop treatment in the follow-up (HR 0.956, p > 0.05). The results indicate that COVID-19 did not affect the duration of treatment and the relative OS.

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