Effect of ruxolitinib on the oral mucosa of patients with steroid-refractory chronic Graft-versus-Host disease and oral involvement

Martina Kaurinovic*, Konstantina Delli, Ana-Mae E. Jonk, Anouschka Biswana, Carin L. E. Hazenberg, Goda Choi, Marco R. de Groot, Linde M. Morsink, Arjan Vissink, Mar Bellido

*Corresponding author for this work

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Abstract

BACKGROUND: Chronic Graft-versus-Host Disease (cGVHD) can impact quality of life, especially in patients with oral involvement. Half of the patients with cGVHD do not respond to first-line therapy with corticosteroids and calcineurin inhibitors. Ruxolitinib is effective in steroid-refractory (SR)-cGVHD cases, but the long-term effects of ruxolitinib on the oral mucosa are unknown.

OBJECTIVE(S): This study aims to assess the effect of ruxolitinib on the oral mucosa of SR-cGVHD patients with oral involvement.

MATERIALS AND METHODS: An observational longitudinal patient study was conducted in 53 patients with SR-cGVHD and oral involvement who were treated with ruxolitinib. The baseline condition of the oral mucosa was compared to its condition at 4 and 12 weeks after starting ruxolitinib.

RESULTS: The overall response was 81% (43/53), with a complete response in 53% (28/53) and partial response in 28% (15/53) after 12 weeks (p < 0.001). Men and patients concurrently using immunosuppressive therapy responded better than women (p = 0.005) and patients with ruxolitinib monotherapy (p = 0.02), respectively. At a longer follow-up (median 20 months), oral symptoms were comparable to the 12-week symptoms (p = 0.78), regardless of ruxolitinib use (p = 0.83).

CONCLUSION: Ruxolitinib treatment of SR-cGVHD patients with oral involvement was associated with a significant response of the oral manifestations at 12 weeks.

CLINICAL RELEVANCE: The oral mucosa of SR-cGVHD patients is likely to improve after 4 and 12 weeks of ruxolitinib treatment. Symptom severity at baseline does not affect the response of the oral mucosa.

Original languageEnglish
Pages (from-to)4209–4216
Number of pages8
JournalClinical Oral Investigations
Early online date16-Feb-2022
DOIs
Publication statusPublished - 2022

Keywords

  • Graft vs host disease
  • Mouth mucosa
  • INCB018424
  • Immunosuppression
  • CONSENSUS DEVELOPMENT PROJECT
  • MEASURING THERAPEUTIC RESPONSE
  • CLINICAL-TRIALS
  • CRITERIA
  • VALIDATION
  • DIAGNOSIS

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