Incyte’s JAK inhibitor may play a role in stopping COVID-19-associated cytokine storms.
Incyte is starting RUXCOVID, a global, randomized, double-blind, placebo-controlled Phase 3 clinical trial evaluating the efficacy and safety of ruxolitinib (Jakafi) plus standard-of-care (SoC) in patients aged ≥12 years with COVID-19-associated cytokine storm. The collaborative study is sponsored by Incyte in the United States and Novartis outside of the United States.
Additionally, given the urgent nature of the COVID-19 pandemic, Incyte is also initiating a separate emergency Expanded Access Program (EAP) in the United States. The protocol will allow eligible patients with severe COVID-19-associated cytokine storm to receive ruxolitinib while it is being investigated for this indication.
Emerging evidence suggests that regulating overactive signaling through the JAK-STAT pathway during a cytokine storm associated with COVID-19 could be a potential treatment approach, and it is hypothesized that ruxolitinib, a JAK1/JAK2 inhibitor, may be able to play a role in treating these patients.
Currently, there is limited clinical evidence on the safety and efficacy of ruxolitinib for the treatment of COVID-19-associated cytokine storm, and ruxolitinib is not FDA-approved for this use.
There are three JAK inhibitors currently approved for treating rheumatoid arthritis (RA) in the US, and these drugs are also being widely studied in the treatment of atopic dermatitis, alopecia, and other skin diseases.
The composite primary endpoint is the proportion of patients who die, develop respiratory failure (require mechanical ventilation) or require intensive care unit (ICU) care by Day 29. Secondary endpoints comprise various efficacy assessments including evaluation of clinical status using a 9-point ordinal scale; in-hospital outcomes (mortality rate; proportion of patients requiring mechanical ventilation; duration of hospitalization, ICU stay, supplemental oxygen, invasive mechanical ventilation); change in the National Early Warning Score (NEWS2); change in SpO2/FiO2 ratio; proportion of patients with no oxygen therapy (oxygen saturation of ≥94% on room air); and safety. RUXCOVID will enroll approximately 400 patients globally.
RUXCOVID is the first Phase 3, randomized, placebo-controlled study designed to evaluate the efficacy and safety of ruxolitinib in patients with COVID-19-associated cytokine storm. At present, there is ample commercial and clinical supply of ruxolitinib in the United States to meet the needs of U.S. patients receiving ruxolitinib in its approved indications and those participating in clinical trials. Incyte is increasing manufacturing efforts to respond to anticipated supply needs related to COVID-19 studies and working closely with distribution partners to monitor the supply of ruxolitinib.
“There is an unprecedented unmet medical need for treatments that prevent or reduce severe COVID-19-related complications to improve outcomes for patients and alleviate the overwhelming pressure on the global healthcare system,” says Steven Stein, MD, Chief Medical Officer, Incyte, in a news release. “We thank the FDA for the expedited review of the RUXCOVID study and hope to enroll this important clinical trial as quickly as possible to determine the potential utility of ruxolitinib for treatment of patients with severe COVID-19 associated cytokine storm.”