Evidence map›Paper›PMID 39281381›Full record

SynthesisFrontiers in oncology2024

Comparative efficacy and hematologic safety of different dosages of JAK inhibitors in the treatment of myelofibrosis: a network meta-analysis.

Ke Chen, Yanyu Zhang, Jixuan Zou, Dehao Wang, Xinyue Yu, Yan Sun, Yumeng Li, Jicong Niu, Yi Chen, Pei Zhao and 4 more

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Ke Chen *Postdoctoral Research Station of China Academy of Chinese Medical Sciences, Beijing, China.
Yanyu Zhang *Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Jixuan ZouDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Dehao WangDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xinyue YuDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yan SunDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yumeng LiDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Jicong NiuDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yi ChenDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Pei ZhaoDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Weiyi LiuDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yan LvDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Mingjing WangDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xiaomei HuDepartment of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Myelofibrosis (MF) is a myeloproliferative neoplasm characterized by bone marrow fibrosis associated with substantial morbidity and mortality. The therapeutic landscape for MF has advanced with the development of Janus kinase inhibitors (JAKis) like ruxolitinib (RUX), fedratinib (FED), pacritinib (PAC), and momelotinib (MMB), aiming to alleviate symptoms and enhance patient comfort. Methods: A network meta-analysis was conducted to assess the efficacy and safety of eleven JAKi treatment regimens across nine randomized controlled trials (RCTs) with a total of 2340 participants. Outcomes were evaluated in terms of spleen volume reduction (SVR), total symptom score reduction (TSSR), hematological safety profiles, and overall survival (OS). Results: RUX and MMB were superior in achieving SVR and TSSR, with significant dose-response relationships observed. PAC and MMB were associated with a decreased risk of grade 3/4 anemia and thrombocytopenia compared to other JAKis. However, no substantial benefits in OS were observed with newer JAKis compared to RUX. The poorer OS outcomes with certain PAC dosages were likely influenced by baseline patient characteristics, particularly severe cytopenias. Conclusion: The introduction of JAKis significantly changed the treatment of MF. This meta-analysis reaffirms the core role of RUX and positions MMB as a potentially powerful alternative for treating symptoms and reducing spleen size. Meanwhile, MMB and PAC have a positive effect on anemia in MF while FED is more tolerable for patients with thrombocytopenia. However, it should be noted that these results are influenced by baseline patient characteristics, particularly cytopenias, which affects both management and overall survival. Therefore, there is an urgent need for personalized dosing strategies to optimize the balance between efficacy and safety, with careful consideration of patient-specific factors. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023424179.

Indexed as

different doseshematological safetyJAK inhibitormyelofibrosisnetwork meta-analysis

Identifiers

PMID39281381
PMCPMC11392783

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.