# Clinical Outcomes of Ruxolitinib Treatment in Patients With IPSS Intermediate‐1‐Risk Myelofibrosis: Interim Analysis From an Italian, Prospective Study (ROMEI)

**Authors:** Paola Guglielmelli, Massimo Breccia, Francesco Mendicino, Maurizio Martelli, Nicola Di Renzo, Giuseppe A. Palumbo, Monica Crugnola, Maurizio Musso, Silvia Sibilla, Paolo Sportoletti, Elisabetta Abruzzese, Stefana Impera, Alessandra Malato, Sergio Siragusa, Carmine Selleri, Fabrizio Pane, Bruno Martino, Alessandra Ricco, Angelo Gardellini, Anna Marina Liberati, Agostino Tafuri, Maria Langella, Marco Brociner, Paolo Ditonno, Domenico Pastore, Olga Mulas, Barbara Pocali, Marco De Gobbi, Erika Morsia, Giulia Benevolo, Elena Maria Elli, Valerio De Stefano, Antonietta Pia Falcone, Daniele Vallisa, Simona Tomassetti, Francesca Lunghi, Nicola Orofino, Giuseppe Carli, Tiziana Urbano, Alessandro Lucchesi, Marta Brunoventre, Massimiliano Bonifacio, Gianni Binotto, Francesco Cavazzini, Paola Ranalli, Alessandro Allegra, Barbara Anaclerico, Serena Mazzotta, Filippo Gherlinzoni, Mario Tiribelli, Chiara Castiglioni, Marina Landoni, Diletta Valsecchi, Michela Magnoli, Francesco Passamonti, Francesca Palandri

PMC · DOI: 10.1002/hon.70178 · 2026-03-25

## TL;DR

This study shows that ruxolitinib improves symptoms and quality of life in patients with intermediate-1 risk myelofibrosis, with manageable side effects.

## Contribution

The study provides new clinical evidence on ruxolitinib's efficacy and safety in a specific myelofibrosis risk group.

## Key findings

- 42.1% and 43.9% of patients showed symptom improvement at 24 and 48 weeks.
- Quality of life scores improved after treatment, with manageable safety and acceptable toxicity.

## Abstract

Ruxolitinib (RUX), a JAK1/2 inhibitor, demonstrated treatment benefits for myelofibrosis (MF) in intermediate‐1 (Int‐1)–risk patients with a significant disease burden; however, the evidence is scarce. This interim analysis investigated the efficacy and safety of ruxolitinib in patients with Int‐1‐risk MF. ROMEI, a multicenter, observational, prospective study, enrolled 508 adult patients with MF receiving ruxolitinib according to approved indications. The present interim analysis was focused on 107 eligible patients in the Int‐1‐risk group. Primary endpoints included changes in symptoms response and health‐related quality of life scores. Secondary endpoints included spleen response evaluation, overall survival, and safety including dosing pattern and dose interruptions. Among the 107 Int‐1‐risk patients with a median age of 63 years, 65.5% were highly symptomatic (total symptoms score: ≥ 20), while the spleen was palpable at ≥ 5 cm and ≥ 10 cm in 74% and 27% of patients, respectively, with baseline EuroQol visual analogue scale (EQ‐VAS) score of 65.1 ± 19.4. After RUX treatment, 42.1% and 43.9% of patients demonstrated a symptom response at 24 and 48 weeks, while 38.9% and 46.8% showed a spleen response at 24 and 48 weeks, respectively. EQ‐VAS increased to 71.8 ± 16.3 at 24 weeks and 69.3 ± 19.2 at 48 weeks. Furthermore, 11.2% and 25.2% of patients reported temporary and permanent discontinuation, respectively with no new adverse events reported. The interim analysis showed that ruxolitinib provided clinical benefits, a manageable safety profile, and improved quality of life for Int‐1‐risk subgroup patients with frequent and sustained responses with acceptable toxicity.

## Linked entities

- **Proteins:** JAK1 (Janus kinase 1), JAK2 (Janus kinase 2)
- **Chemicals:** ruxolitinib (PubChem CID 17754772)
- **Diseases:** myelofibrosis (MONDO:0044903)

## Full-text entities

- **Genes:** JAK2 (Janus kinase 2) [NCBI Gene 3717] {aka JTK10}, JAK1 (Janus kinase 1) [NCBI Gene 3716] {aka AIIDE, JAK1A, JAK1B, JTK3}
- **Diseases:** acute myocardial infarction (MESH:D009203), MPN 10 (MESH:D009369), heart failure (MESH:D006333), SARS-CoV-2 (MESH:D000086382), thrombocytopenia (MESH:D013921), cerebral bleeding (MESH:D002543), cysts and polyps (MESH:D011127), splenomegaly (MESH:D013163), death (MESH:D003643), pneumonia (MESH:D011014), toxicity (MESH:D064420), anemia (MESH:D000740), sudden death (MESH:D003645), MF (MESH:D055728), OS (MESH:D011475)
- **Chemicals:** RUX (MESH:C540383), SOC (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13014119/full.md

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Source: https://tomesphere.com/paper/PMC13014119