Ruxolitinib
Ruxolitinib
- Pregnancy category C
- Jakavi, Jakafi
- Topical, oral
- JAK1/2
FDA
- Steroid-refractory acute graft versus host disease (GVHD)
- Myelofibrosis
- Polycythemia Vera
Off-label
- Atopic dermatitis
- Psoriasis
- Alopecia areata (recurrence of alopecia areata observed after discontinuation)
- Vitiligo
Reports
- Cutaneous manifestations of dermatomyositis
- Chronic spontaneous urticaria
- Cutaneous sarcoidosis
- Hypereosinophilic syndrome
- Chilblain lupus
- Chronic mucocutaneous candidiasis
- Pyoderma gangrenosum
- Pembrolizumab-induced rash
Infections
- Nasopharyngitis & upper respiratory tract infections (most common), bacterial, fungal, viral & opportunistic infections
Cardiovascular
- Bradycardia & prolong PR interval
- Hemorrhage
Cutaneous
- Non-melanoma skin cancers (report of eruptive cutaneous squamous cell carcinoma), Drug rash with eosinophilia and systemic symptoms (DRESS)
Laboratory changes
- Anemia
- Neutropenia
- Thrombocytopenia
- Hyperlipidemia
* For topical Ruxolitinib, systemic side effects observed with application >10% body surface area or 3.75g
- Strong CYP3A4 inhibitors increase toxicity; if to be co-administered, reduce Ruxolitinib dose by 50%
Baseline
- Complete blood count with differential
- Electrolytes
- Liver function tests
- Lipid profile
- Hepatitis B & C
- Tuberculosis evaluation
- Pregnancy test
Follow up
- Annual physical exam for skin cancers
- Monitor for signs/symptoms of infections including tuberculosis
- Complete blood count with differential
- Liver function test
- Lipid profile
- Repeat labs every 4-8 weeks after initiation, then every 3 months
Notes
- Discontinue if ANC <500
- Avoid live vaccines