Published on June 3, 2020
JAK inhibitors, a treatment for patients with myeloproliferative neoplasms (MPN), may help reduce the severity of COVID-19, the respiratory disease caused by the coronavirus.
In fact, JAK inhibitors are in Phase III trials for COVID-19, said Dr. Raajit Rampal, a hematologic oncologist from Memorial Sloan Kettering Cancer Center in New York City. Dr. Rampal participated in a Patient Power webinar last month about MPN patients and COVID-19.
“That's owing to the idea that there is a massive cytokine storm that seems to occur during the course of the (COVID-19) infection that we think, at least, is contributing to what happens in the lungs,” he told Patient Power Co-Founder Andrew Schorr. “And so, of course, the JAK inhibitors are wonderful drugs to inhibit cytokines.”
Dr. Srdan Verstovsek, a medical oncologist at MD Anderson Cancer Center in Houston, agreed that the potential role of JAK inhibitors in COVID-19 patients deserves further study.
“JAK inhibitors predispose patients to acquire infections, viral infections,” said Dr. Verstovsek, who joined Rampal on the webinar. “You would say, ‘Well, that's not good, because COVID is a viral infection.’ On the other hand, as it was very well explained, it might actually decrease when it is given to patients with infection, inflammation that affects the lungs.”
Dr. Rampal noted that several of his patients—who had contracted COVID-19 and were on JAK inhibitors—were able to recover at home, but it’s unclear whether that was because of the drug or other factors. He said those patients had the “typical” COVID-19 symptoms—cough, shortness of breath and fever.
He reminded webinar participants that recovery from COVID-19 often depends on the patient’s health, such as whether they have other conditions that would place them at higher risk.
“Certainly, we've had experience with MPN patients being infected,” he said. “But I would say it's hard to draw conclusions about, ‘Do patients take one particular course when they do get sick?’”
Dr. Verstovsek concurred, noting that an older MPN patient with co-morbidities will be more susceptible to infection. He also said patients with advanced myelofibrosis (MF), which is known to affect the immune system, may be more prone to COVID-19 than those with essential thrombocythemia (ET) or polycythemia vera (PV).
Both doctors said they are following guidance from the American Society of Hematology and continuing to treat MPN patients.
“We shouldn't modify treatment just because of COVID, but rather I think the important thing is to emphasize to our patients to take protective measures, particularly those who are at a more advanced stage of disease, but I think also patients who are on active treatment,” Dr. Rampal said. “I think the principles should still apply that we want to maximize our protective and precautionary measures and minimize our exposures.”
However, clinical trials, investigational studies and transplants are being postponed unless absolutely necessary because of the monitoring and frequent office visits that are required.
Similarly, bone marrow biopsies are only being done if the results would affect treatment decisions or the patient’s prognosis.
“The availability of (COVID) testing, widespread testing, which in some areas of the United States perhaps is not very optimal as of yet, will help us engage patients in a transplant much faster than it is now,” Dr. Verstovsek said. “And the same to extend the discussion applies to the engagement of the patients in the clinical studies with normal medications.”
The discussion of reducing exposure risk prompted Michelle Woehrle to suggest patients consider telemedicine. Woehrle, who joined Drs. Rampal and Verstovsek on the webinar, has since stepped down as Executive Director of the MPN Research Foundation.
“Certainly, let their doctors know what they're going through,” she said, referring to MPN patients. “And since there are patients who are on this program, they should really hear that Dr. Verstovsek and Dr. Rampal want to hear from them. So, they should feel empowered and encouraged to not be shy and ask for what they need.”
Woehrle said she hopes some of the ways the world is working to fight COVID-19 are going to be applicable to other diseases such as MPNs.
“I just get excited about tapping into these new ways of looking at the world and how quickly trials are being put up there, and how is that going to positively impact the people living with an MPN?” she said.
“In all the terrible headlines that we're seeing, what I come away with is still a persistent dose of hope,” she added. “I hope that the people who are watching this, who are living with an MPN, can feel that as well.”
Watch a replay of the webinar and read the transcript:
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