Aaron Gerds, MD, MS

January 19, 2024

Patients with myelofibrosis should reflect on their personal priorities and quality of life goals, understand the range of available JAK inhibitor treatment options, and openly communicate with their doctor to arrive at a shared decision for managing their disease.

January 12, 2024

For most JAK inhibitors dosing starts at the maximum safe dose, while ruxolitinib often requires lower initial doses and dose reductions over the first 12 weeks when cytopenias typically worsen before partially improving, warranting consideration of earlier switching to alternative JAK inhibitors instead of pushing through transfusions.

January 12, 2024

Reasons to switch JAK inhibitors include worsening blood counts and insufficient symptom or spleen response at maximum doses, with the goal of avoiding gaps in treatment by stopping one JAK inhibitor when ready to start the next to prevent symptom rebound while still allowing for potential increased efficacy from an alternative mechanism of action.

January 05, 2024

Response is assessed in patients starting a JAK inhibitor by monitoring symptoms on a severity scale, spleen size, blood counts, and overall patient impression of change, with the goal being reduction of symptoms and stabilization of blood counts to improve quality of life.