骨髓纤维化
医学
临床试验
虚假关系
贾纳斯激酶
鲁索利替尼
内科学
计算机科学
机器学习
细胞因子
骨髓
作者
John Mascarenhas,Ruben A. Mesa
标识
DOI:10.1016/j.clml.2023.06.004
摘要
With multiple Janus Kinase (JAK) inhibitors approved or in late development for myelofibrosis, there is a logical desire in the field for comparative efficacy and safety data among these agents in order to inform treatment selection. However, due to the highly disparate nature of patient populations enrolled in different JAK inhibitor trials, as well as key differences in study design, any cross-study comparative analyses should be undertaken with a high degree of caution. Here, we show how differences in enrolled populations can impact both efficacy and safety conclusions and why quantitative comparisons of outcomes across studies is prone to spurious conclusions. We conclude by offering guidance on how to approach comparative analyses in the absence of direct head-to-head data based on a thorough understanding of how study design impacts outcomes. Ultimately there is enough room in the myelofibrosis treatment landscape for multiple JAK inhibitors, and sequencing of therapies should depend on how each agent was studied and where it showed the most benefit, both in trials and in real-world practice.
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