MOMENTUM
MOMENTUM showed that momelotinib, a JAK inhibitor that also eases anaemia, relieved symptoms and shrank spleens better than danazol in people with myelofibrosis who were anaemic after earlier JAK inhibitor treatment.
Overview
Anaemia is the weak point of the first JAK inhibitors: ruxolitinib and fedratinib worsen it. Momelotinib inhibits JAK1, JAK2 and ACVR1, the last of which lowers hepcidin and improves red cell production. MOMENTUM randomised 195 patients with symptomatic myelofibrosis, anaemia and prior JAK inhibitor treatment to momelotinib or to danazol, an androgen used for anaemia in this disease. The primary endpoint was the proportion with a 50 percent or greater reduction in total symptom score at week 24.
Momelotinib met the primary endpoint and also improved transfusion independence and spleen volume response compared with danazol. It was approved in the United States in September 2023 for myelofibrosis with anaemia, the first JAK inhibitor labelled for that group.
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