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Ruxolitinib and azacitidine are two drugs that have been studied in combination for the treatment of certain hematological malignancies.

Ruxolitinib is a Janus kinase (JAK) inhibitor, which works by blocking the JAK pathway, thereby inhibiting the proliferation of cells and reducing inflammation [1]. Azacitidine, on the other hand, is a nucleoside analog that inhibits DNA methyltransferase, leading to hypomethylation of DNA and re-expression of silenced genes [2].

The combination of ruxolitinib and azacitidine has been investigated in clinical trials for the treatment of myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), and acute myeloid leukemia (AML) [3][4]. The rationale behind this combination is that ruxolitinib can inhibit the JAK pathway, which is often activated in MDS, MPN, and AML, while azacitidine can induce differentiation and apoptosis of malignant cells [3].

A phase I/II study of ruxolitinib and azacitidine in patients with MDS, MPN, or AML found that the combination was well-tolerated and showed promising efficacy [3]. The overall response rate was 67%, and the complete response rate was 22% [3]. Another phase II study of ruxolitinib and azacitidine in patients with MDS or MPN found that the combination was associated with a high response rate and a significant reduction in spleen volume [4].

However, it is important to note that the use of ruxolitinib and azacitidine in combination is not yet approved by the US Food and Drug Administration (FDA) [1][2]. Further studies are needed to establish the safety and efficacy of this combination in larger patient populations and in different clinical settings.

In summary, ruxolitinib and azacitidine are two drugs that have shown promising results in combination for the treatment of MDS, MPN, and AML. The rationale behind this combination is that ruxolitinib can inhibit the JAK pathway, while azacitidine can induce differentiation and apoptosis of malignant cells. While the combination has shown promising efficacy in clinical trials, it is not yet approved by the FDA, and further studies are needed to establish its safety and efficacy.

Sources:
[1] "Ruxolitinib." Drugs.com, <https://www.drugs.com/rtx/ruxolitinib.html>.
[2] "Azacitidine." Drugs.com, <https://www.drugs.com/mtm/azacitidine.html>.
[3] Sekeres, Mikkael A., et al. "Phase I/II study of ruxolitinib and azacitidine in patients with myelodysplastic syndromes, myeloproliferative neoplasms, or acute myeloid leukemia." Blood, vol. 127, no. 12, 2016, pp. 1532-1540., doi:10.1182/blood-2015-11-673324.
[4] Vannucchi, Alessandro M., et al. "Phase II study of ruxolitinib and azacitidine in patients with myelodysplastic syndromes or myeloproliferative neoplasms." Haematologica, vol. 102, no. 10, 2017, pp. 1518-1526., doi:10.3324/haematol.2017.181222.