{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:54:46Z","timestamp":1791446086491,"version":"4.3.3"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370192"],"award-info":[{"award-number":["82370192"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82500255"],"award-info":[{"award-number":["82500255"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U24A20680"],"award-info":[{"award-number":["U24A20680"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"1.3.5 Project of High-Altitude Medicine","award":["GYYX24003"],"award-info":[{"award-number":["GYYX24003"]}]},{"name":"1\u00b73\u00b75 project for disciplines of excellence\u2013Clinical Research Fund, West China Hospital, Sichuan University","award":["2024HXFH041"],"award-info":[{"award-number":["2024HXFH041"]}]},{"name":"\u201cQimingxing\u201d Research Fund for Young Talents","award":["HXQMX0031"],"award-info":[{"award-number":["HXQMX0031"]}]},{"name":"Natural Science Foundation of Sichuan Province, China","award":["2024NSFSC1701"],"award-info":[{"award-number":["2024NSFSC1701"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myelofibrosis is a debilitating neoplasm with progressive bone marrow fibrosis, splenomegaly, and leukemic transformation risk. While ruxolitinib remains the standard for intermediate\/high-risk MF, new strategies, including novel JAK inhibitors and ruxolitinib-based combinations, aim to improve efficacy and safety. However, direct comparisons of these strategies in JAK inhibitor-na\u00efve patients remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of ruxolitinib, novel inhibitors, and combinations in JAKi-na\u00efve MF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review and network meta-analysis of RCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Methods<\/jats:title>\n                    <jats:p>We searched electronic databases through November 2025 for RCTs evaluating JAK inhibitors in JAKi-na\u00efve MF. The efficacy endpoints were spleen volume reduction of \u226535% (SVR35) and total symptom score reduction of \u226550% (TSS50) at week 24. Safety outcomes included adverse events (AEs) as well as treatment discontinuation rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven RCTs (n=2,254) were analyzed. Ruxolitinib combinations significantly improved SVR35 over ruxolitinib (OR = 3.63) but not TSS50. Momelotinib showed comparable SVR35 (OR = 0.886), while selective JAK2 inhibitors (fedratinib and pacritinib) were numerically inferior in efficacy. Regarding safety, fedratinib had the lowest risk of grade \u22653 thrombocytopenia (OR = 0.204); pacritinib, the lowest risk of all-grade thrombocytopenia (OR = 0.209); momelotinib, the lowest risk of all-grade anemia (OR = 0.226) and grade \u22653 anemia (OR=0.187). JAK2 inhibitors significantly increased diarrhea risk (OR=6.19). Notably, ruxolitinib monotherapy maintained the lowest AEs-related discontinuation rates in patients with platelets \u2265 50\u00d710^9\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In first-line therapy, our findings support a stratified approach. Ruxolitinib combinations are preferred for patients where maximal splenic debulking is the primary goal. Selective JAK2 inhibitors provide a safe option for patients with profound thrombocytopenia. Momelotinib matches ruxolitinib\u2019s efficacy via JAK1\/2 inhibition while being optimal for baseline anemia via ACVR1 inhibition. Crucially, ruxolitinib remains the benchmark for symptom control and treatment retention in patients with adequate platelets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>CRD420261330640.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207261484707","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:02:57Z","timestamp":1788346977000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy and safety of JAK inhibitor-based strategies in JAK inhibitor-na\u00efve myelofibrosis: A systematic review and network meta-analysis"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1295-3431","authenticated-orcid":false,"given":"Zhongwang","family":"Wang","sequence":"first","affiliation":[{"name":"Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Niu","sequence":"additional","affiliation":[{"name":"Sichuan University"},{"name":"Sichuan University"},{"name":"Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Li","sequence":"additional","affiliation":[{"name":"Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23703"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22365"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110557"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110556"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.119545"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000001"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-017-3194-4"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.1590"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(17)30027-3"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03572-3"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-173509"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.73.4418"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2025.288654"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1403967"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00526-z"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2023.2300710"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02188"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27248"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S7224"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12092381"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2010.248"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.9490"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002028"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/158514"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2009.01.035"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.48101\/ujms.v128.9785"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-024-03855-1"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16576"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-214957"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.5818"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003314"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-740092"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000963"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccr.2008.02.009"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2024.2372453"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2025.288654"},{"key":"e_1_3_7_40_2","first-page":"S222","article-title":"EFFICACY AND SAFETY OF NAVITOCLAX IN COMBINATION WITH RUXOLITINIB VERSUS RUXOLITINIB PLUS PLACEBO IN PATIENTS WITH UNTREATED MYELOFIBROSIS IN THE PHASE 3 RANDOMIZED, DOUBLE-BLIND TRANSFORM-1 STUDY","volume":"8","author":"Pemmaraju N","year":"2024","unstructured":"Pemmaraju N. EFFICACY AND SAFETY OF NAVITOCLAX IN COMBINATION WITH RUXOLITINIB VERSUS RUXOLITINIB PLUS PLACEBO IN PATIENTS WITH UNTREATED MYELOFIBROSIS IN THE PHASE 3 RANDOMIZED, DOUBLE-BLIND TRANSFORM-1 STUDY. 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