Can momelotinib be discontinued suddenly and analysis of the risks of discontinuation

Momelotinib is an oral JAK inhibitor mainly used in patients with myelofibrosis to improve anemia and myelofibrosis-related symptoms. Because it acts on the cell signaling pathway, sudden discontinuation of the drug may cause the drug's effect to disappear quickly and the patient's symptoms to rebound quickly, including worsening of anemia, obvious splenomegaly, or worsening of general weakness, etc. Therefore, it is not recommended to interrupt the medication on your own. Discontinuation of medication must be done under the guidance of a doctor, and a gradual reduction or alternative plan should be developed based on the patient's condition to reduce risks.

The risk of drug discontinuation is mainly reflected in the rebound of disease symptoms and blood picture fluctuations. Some studies and clinical observations have shown that after discontinuation of molotinib, patients may experience decreased platelets, abnormal white blood cells, and decreased erythropoiesis. At the same time, symptoms of anemia and splenomegaly that are originally under control may worsen in a short period of time, and even require emergency intervention in severe cases. Therefore, a comprehensive evaluation, including blood routine, liver and kidney function, and spleen size monitoring, should be carried out before discontinuation to ensure safety.

In addition, sudden discontinuation may affect long-term efficacy and tolerability. During long-term use, molotinib maintains the inhibition of the JAK signaling pathway through steady-state blood concentration. Sudden interruption may break this balance, resulting in the drug being less effective than continuous medication or requiring a higher dose when the drug is subsequently restarted. For patients under long-term treatment, doctors usually develop a gradual reduction plan based on symptom control and laboratory indicators to ensure that the drug can be stopped safely while keeping the disease as stable as possible.

In general, molotinib should not be stopped suddenly. Patients should evaluate the necessity of drug discontinuation under the guidance of a professional physician, strictly follow dose reduction or alternative treatment plans, and strengthen blood and symptom monitoring. Once anemia worsens, splenomegaly becomes apparent, or other discomfort occurs, you should contact your doctor immediately to adjust the plan. Sequential drug withdrawal and standardized monitoring are key to ensuring patient safety, avoiding disease recurrence, and maintaining therapeutic efficacy.

Reference materials:https://go.drugbank.com/