Improved Benefit of Continuing Luspatercept Therapy: Sub-analysis of Patients With Lower-Risk MDS in the Medalist Study

Authors

Ulrich Germing
Pierre Fenaux
Uwe Platzbecker
Rena Buckstein
Valeria Santini
María Díez-Campelo
Aylin Yucel
Derek Tang
Shannon Fabre
George Zhang
Roberto Zoffoli
Xianwei Ha
Dimana Miteva
Christina Hughes
Rami S Komrokji
Amer M Zeidan
Guillermo Garcia-Manero

Language

English

Publication Date

2-1-2023

Journal

Annals of Hematology

DOI

10.1007/s00277-022-05071-8

PMID

36635381

PMCID

PMC9889415

PubMedCentral® Posted Date

1-13-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Red blood cell transfusion independence (RBC-TI) is an important goal in treating lower-risk myelodysplastic syndromes with ring sideroblasts. In the phase 3 MEDALIST study, RBC-TI of ≥ 8 weeks was achieved by significantly more luspatercept- versus placebo-treated patients in the first 24 weeks of treatment. In this post hoc analysis, we evaluated RBC transfusion units and visits based on patients' baseline transfusion burden level and the clinical benefit of luspatercept treatment beyond week 25 in initial luspatercept nonresponders (patients who did not achieve RBC-TI ≥ 8 weeks by week 25) but continued luspatercept up to 144 weeks. RBC transfusion burden, erythroid response, serum ferritin levels, and hemoglobin levels relative to baseline were evaluated. Through week 25, fewer RBC transfusion units and visits were observed in luspatercept-treated patients versus placebo, regardless of baseline transfusion burden. This continued through 144 weeks of luspatercept treatment, particularly in patients with low baseline transfusion burden. Sixty-eight patients were initial nonresponders at week 25 but continued treatment; most (81%) received the maximum dose of luspatercept (1.75 mg/kg). Sixteen percent achieved RBC-TI for ≥ 8 weeks during weeks 25-48, 26% had reduced RBC transfusion burden, 10% achieved an erythroid response, 44% had reduced serum ferritin, and hemoglobin levels increased an average of 1.3 g/dL from baseline. These data have implications for clinical practice, as transfusion units and visits are less in luspatercept-treated patients through week 25 regardless of baseline transfusion burden, and continuing luspatercept beyond week 25 can potentially provide additional clinical benefits for initial nonresponders.

Keywords

Humans, Ferritins, Hemoglobins, Immunoglobulin Fc Fragments, Myelodysplastic Syndromes, Recombinant Fusion Proteins, Activin Receptors, Type II, Myelodysplastic syndromes, Anemia, Luspatercept, Red blood cell transfusion independence, Health-related quality of life

Comments

Trial registration: NCT02631070.

Published Open-Access

yes

Recommended Citation

Germing, Ulrich; Fenaux, Pierre; Platzbecker, Uwe; et al., "Improved Benefit of Continuing Luspatercept Therapy: Sub-analysis of Patients With Lower-Risk MDS in the Medalist Study" (2023). Faculty, Staff and Student Publications. 5719.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5719