Incyte announces results from the phase III DEVENT study of Jakafi for COVID-19 associated acute respiratory distress syndrome patients on mechanical ventilation.

Incyte announced results from the Phase III DEVENT study evaluating the efficacy and safety of ruxolitinib (5mg and 15mg) plus standard of care (SoC) versus SoC in patients on mechanical ventilation with COVID-19 associated Acute Respiratory Distress Syndrome (ARDS), a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. While results indicate a trend towards an improvement in mortality in the overall study population (N=211), the DEVENT study did not meet its primary endpoint—mortality due to any cause through day 29—adjusted for ARDS severity between the two treatment arms versus placebo (55.2% vs. 74.3% [Odds Ratio (OR): 0.42 (95% CI: 0.171-1.023)], P=0.0280 in the 5mg arm and 51.8% vs. 69.6% [OR: 0.46 (95% CI: 0.201-1.028)], P=0.0292 in the 15mg arm). In the U.S. study population (N=191), which accounts for the majority (91%) of the DEVENT study patients, there was a clinically and statistically significant improvement in mortality in each of the 5mg (46.7% vs. 69.1% [OR: 0.39 (95% CI: 0.157-0.948)], P=0.0189) and 15mg treatment arms (47.1% vs. 66.7% [OR: 0.43 (95% CI: 0.188-0.974)], P=0.0215) versus placebo, respectively. Additionally, a post-hoc analysis of the overall study population pooling both the 5mg and 15mg ruxolitinib arms together versus placebo, showed a statistically significant improvement in mortality (53.6% vs. 70.7% [OR: 0.47 (95% CI: 0.219-0.996)], P=0.0244). More than half of study patients (55%) received remdesivir and 90% of study patients received corticosteroids prior to or during the study. The safety profile was generally consistent with hospitalized patients with COVID-19 and consistent with treatment with ruxolitinib. The most common adverse events on the ruxolitinib arms, regardless of dose, compared to placebo were anemia (20.7% vs. 22.2%), increased alanine aminotransferase (ALT, 14.6% vs. 13.3%), increased aspartate transaminase (AST, 14.0% vs. 8.9%) and hypertension (11.6% vs. 11.1%), respectively. Given the urgent nature of the COVID-19 pandemic, Incyte plans to make ruxolitinib available to eligible patients in the United States at no cost via an Expanded Access Program (EAP) pending agreement with the U.S. Food and Drug Administration. The protocol will allow eligible patients with severe COVID-19 associated ARDS with disease severity requiring mechanical ventilation to receive ruxolitinib.