Ruxolitinib is in clinical development for chronic graft versus host disease (cGvHD). After a donor stem cell transplant, the donor’s stem cells (the graft) may sometimes react against the host’s own cells. This is called GVHD. cGvHD may happen more than three months after transplant. It can develop from acute GVHD or happen on its own. The symptoms depend on which parts of the body are affected. They may include skin changes, hair that grows slowly, feeling short of breath or wheezy, dry and swollen mouth and mouth ulcers, dry, gritty eyes, diarrhoea, stomach cramps, sickness and loss of appetite, vaginal narrowing and dryness, repeated infections, and muscle weakness and joint pain. Current standard treatment includes the use of steroids but this is often associated with significant side effects. Steroid resistance in GvHD may also develop which is difficult to treat and associated with a high mortality.
Ruxolitinib works by blocking the action of enzymes known as Janus kinases (JAKs), which are involved in the production and growth of blood cells and immune function. By blocking JAKs, ruxolitinib reduces the abnormal production of blood cells, thereby reducing the symptoms of the diseases. Ruxolitinib is administered as oral tablets and if licenced, will offer an additional therapy option for patients’ steroid-refractory cGvHD after allogeneic hematopoietic stem cell transplantation.
Anifrolumab is a drug designed to specifically block type I IFN signalling by binding to part of the type I IFN receptor and therefore preventing activity of all IFNs that are involved in the inflammatory pathway. If licensed, anifrolumab will offer an add-on treatment option for patients with moderately to severely active SLE.