Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Ruxolitinib
Drug ID BADD_D01978
Description Ruxolitinib, formerly known as INCB018424 or INC424, is an anticancer drug and a Janus kinase (JAK) inhibitor. It is a potent and selective inhibitor of JAK1 and JAK2,[A229698] which are tyrosine kinases involved in cytokine signalling and hematopoiesis.[A7450] Myeloproliferative neoplasms, such as myelofibrosis and polycythemia vera, are often characterized by aberrant activation of the JAK-STAT pathway, leading to abnormal blood cell counts and thrombotic complications. By inhibiting JAK1 and JAK2, ruxolitinib works to block the dysregulated cell signalling pathways and prevents abnormal blood cell proliferation.[A229708] Due to a large number of patients with myeloproliferative neoplasms who have JAK2 mutations, ruxolitinib was the first ATP-competitive inhibitor of JAK1 and JAK2 ever developed.[A229938] Ruxolitinib was first approved for the treatment of adult patients with myelofibrosis by the FDA in 2011, followed by EMA's approval in 2012.[A229708] In 2014, it was approved for the treatment of polycythemia vera in adults who have an inadequate response to or are intolerant of [hydroxyurea] and in 2019, ruxolitinib was approved for use in steroid-refractory acute graft-versus-host disease in adults and children.[L31958] In 2021, ruxolitinib was approved for treatment of mild to moderate atopic dermatitis in patients 12 years and older whose disease was not adequately controlled by topical prescription therapies or when those therapies were not advisable.[L39125] Available as oral tablets, ruxolitinib is commonly marketed under the trade name Jakafi. Ruxolitinib has been investigated to treat patients with coronavirus disease 2019 (COVID-19) accompanied by severe systemic hyperinflammation. In phase II clinical trials, ruxolitinib improved chest computed tomography and improved recovery in patients with lymphopenia.[A229713, A229718] However, phase III clinical trials later determined that ruxolitinib was inadequate in meeting its primary endpoint of reducing the number of hospitalized COVID-19 patients who experienced severe complications.[L31968] Ruxolitinib was not approved as a treatment for COVID-19. The topical formulation of ruxolitinib was investigated to treat vitiligo,[A229723] atopic dermatitis,[A229728] and psoriasis,[A229883] where it showed promising preliminary results in improving the symptoms of inflammatory skin conditions.
Indications and Usage Treatment of intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera (post-PV) myelofibrosis and post-essential thrombocythemia (post-ET) myelofibrosis. [Lexicomp] Myeolofibrosis is the proliferation of abnormal bone marrow stem cells which cause fibrosis (the excessive formation of connective tissue).
Marketing Status Not Available
ATC Code L01EJ01
DrugBank ID DB08877
KEGG ID D09959
MeSH ID C540383
PubChem ID 25126798
TTD Drug ID D04LKS
NDC Product Code 50881-005; 11014-0451; 11014-0449; 63552-049; 11014-0453; 11014-0450; 11014-0452; 63552-052; 50881-025; 50881-015; 50881-010; 63552-050; 50881-007; 50881-020; 63552-053; 63552-051
Synonyms ruxolitinib | 3R)-3-cyclopentyl-3-(4-(7H-pyrrolo(2,3-d)pyrimidin-4-yl)pyrazol-1-yl)propanenitrile | ruxolitinib phosphate | ruxolitinib monophosphate | INCB-18424 phosphate | Jakavi | INCB018424 phosphate | INCB-018424 salt | Jakafi | ruxolitinib (as phosphate) | INCB-018424 phosphate | INCB-018424 | INC-424 | INCB-18424 | INC424 | INCB018424 | INCA24
Chemical Information
Molecular Formula C17H18N6
CAS Registry Number 941678-49-5
SMILES C1CCC(C1)C(CC#N)N2C=C(C=N2)C3=C4C=CNC4=NC=N3
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
AnaemiaMitogen-activated protein kinase 14Q16539T6586426356267
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Escherichia infection11.02.10.0040.000208%Not Available
Metastases to nervous system17.02.10.022; 16.22.02.0190.001066%Not Available
Neutrophil count abnormal13.01.06.0180.001066%Not Available
Blast cell count increased13.01.03.0080.001042%Not Available
Metastatic squamous cell carcinoma16.16.01.0100.000139%Not Available
Extramedullary haemopoiesis01.05.01.0210.000799%Not Available
Mycobacterium abscessus infection11.04.02.0040.000139%Not Available
Graft versus host disease in lung12.02.09.030; 10.02.01.061; 22.01.01.0210.000139%Not Available
Chronic myeloid leukaemia transformation16.01.07.004; 01.10.07.0040.000139%Not Available
Graft versus host disease in gastrointestinal tract12.02.09.028; 10.02.01.059; 07.11.01.0270.000208%Not Available
Internal haemorrhage24.07.01.0720.001332%Not Available
Primary myelofibrosis16.21.03.008; 01.13.03.0080.000556%Not Available
End stage renal disease20.01.03.0190.000208%Not Available
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