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Ruxolitinib

Generic Name
Ruxolitinib
Brand Names
Jakafi, Jakavi, Opzelura
Drug Type
Small Molecule
Chemical Formula
C17H18N6
CAS Number
941678-49-5
Unique Ingredient Identifier
82S8X8XX8H

Overview

Ruxolitinib, formerly known as INCB018424 or INC424, is an anticancer drug and a Janus kinase (JAK) inhibitor. It is a potent and selective inhibitor of JAK1 and JAK2, which are tyrosine kinases involved in cytokine signalling and hematopoiesis. Myeloproliferative neoplasms, such as myelofibrosis and polycythemia vera, are often characterized by aberrant activation of the JAK-STAT pathway, leading to abnormal blood cell counts and thrombotic complications. By inhibiting JAK1 and JAK2, ruxolitinib works to block the dysregulated cell signalling pathways and prevents abnormal blood cell proliferation. Due to a large number of patients with myeloproliferative neoplasms who have JAK2 mutations, ruxolitinib was the first ATP-competitive inhibitor of JAK1 and JAK2 ever developed. Ruxolitinib was first approved for the treatment of adult patients with myelofibrosis by the FDA in 2011, followed by EMA's approval in 2012. In 2014, it was approved for the treatment of polycythemia vera in adults who have an inadequate response to or are intolerant of hydroxyurea and in 2019, ruxolitinib was approved for use in steroid-refractory acute graft-versus-host disease in adults and children. The topical formulation of ruxolitinib is used to treat atopic dermatitis and vitiligo. It is being investigated for other inflammatory skin conditions. Ruxolitinib has been investigated to treat patients with coronavirus disease 2019 (COVID-19) accompanied by severe systemic hyperinflammation. In phase II clinical trials, ruxolitinib improved chest computed tomography and improved recovery in patients with lymphopenia. However, phase III clinical trials later determined that ruxolitinib was inadequate in meeting its primary endpoint of reducing the number of hospitalized COVID-19 patients who experienced severe complications thus the drug was not approved as a treatment for COVID-19.

Indication

Ruxolitinib is indicated for the treatment of the following conditions: Topical ruxolitinib is indicated for:

Associated Conditions

  • Acute Graft-Versus-Host Disease (GVHD)
  • Chronic Graft-Versus-Host Disease
  • Non-segmental Vitiligo
  • Post Polycythemia Vera Myelofibrosis
  • Post-essential Thrombocythemia Myelofibrosis (Post-ET MF)
  • Primary Myelofibrosis (PMF)
  • High risk Myelofibrosis
  • Intermediate risk Myelofibrosis
  • Mild Atopic dermatitis
  • Moderate Atopic dermatitis
  • Refractory Polycythemia vera

Research Report

Published: Jul 11, 2025

Ruxolitinib: A Comprehensive Monograph on a First-in-Class JAK1/2 Inhibitor

Executive Summary

Ruxolitinib represents a landmark achievement in targeted therapy, establishing a new class of medication as the first orally bioavailable small molecule inhibitor of Janus-associated kinases (JAK) 1 and 2 to receive regulatory approval. Initially developed under the code INCB018424, Ruxolitinib has fundamentally altered the therapeutic landscape for patients with myeloproliferative neoplasms (MPNs), offering the first effective treatment for the debilitating splenomegaly and constitutional symptoms associated with intermediate and high-risk myelofibrosis (MF). Its mechanism, which involves the potent and selective inhibition of the JAK-STAT signaling pathway, directly targets the core pathophysiology of these disorders.

The drug's clinical utility has rapidly expanded beyond its initial indication. It is now a standard second-line therapy for polycythemia vera (PV) in patients who are intolerant of or refractory to hydroxyurea. Furthermore, Ruxolitinib has proven to be a critical, life-saving intervention for both adult and pediatric patients with steroid-refractory acute and chronic graft-versus-host disease (GVHD), a severe complication of allogeneic stem cell transplantation for which few effective treatments previously existed.

Demonstrating remarkable versatility, Ruxolitinib has been successfully reformulated as a 1.5% topical cream (Opzelura®) for the treatment of non-segmental vitiligo and atopic dermatitis, extending its immunomodulatory benefits to the field of dermatology. This dual-formulation success underscores the broad applicability of targeting the JAK-STAT pathway in diseases driven by inflammation and immune dysregulation.

Continue reading the full research report

Clinical Trials

Title
Posted
Study ID
Phase
Status
Sponsor
2025/08/19
Not Applicable
Not yet recruiting
2025/07/25
Not Applicable
Not yet recruiting
2025/07/03
Not Applicable
Not yet recruiting
2025/06/24
Phase 2
Not yet recruiting
2025/06/17
Phase 1
Not yet recruiting
City of Hope Medical Center
2025/05/25
Phase 2
Not yet recruiting
Baptist Health South Florida
2025/05/15
Phase 2
Not yet recruiting
2025/05/06
Phase 3
Recruiting
2025/05/06
Phase 3
Recruiting
2025/04/20
Phase 2
Recruiting
John Levine

FDA Drug Approvals

Approved Product
Manufacturer
NDC Code
Route
Strength
Effective Date
Incyte Corporation
50881-015
ORAL
15.0 mg in 1 1
1/31/2023
Incyte Corporation
50881-007
TOPICAL
15 mg in 1 g
9/20/2023
Incyte Corporation
50881-010
ORAL
10.0 mg in 1 1
1/31/2023
Incyte Corporation
50881-020
ORAL
20.0 mg in 1 1
1/31/2023
Incyte Corporation
50881-005
ORAL
5.0 mg in 1 1
1/31/2023
Incyte Corporation
50881-025
ORAL
25.0 mg in 1 1
1/31/2023

NMPA Drug Approvals

Approved Product
Company
Approval Number
Drug Type
Dosage Form
Approval Date
No NMPA approvals found for this drug.

PPB Drug Approvals

Approved Product
Registration No.
Company
Licence No.
Strength
Registration Date
No PPB approvals found for this drug.

Health Canada Drug Approvals

Approved Product
Company
DIN
Dosage Form
Strength
Market Date
No Health Canada approvals found for this drug.

CIMA AEMPS Drug Approvals

Approved Product
Company
Registration Number
Pharmaceutical Form
Prescription Type
Status
JAKAVI 5 MG COMPRIMIDOS
112773005
COMPRIMIDO
Diagnóstico Hospitalario
Commercialized
JAKAVI 10 MG COMPRIMIDOS
112773015
COMPRIMIDO
Diagnóstico Hospitalario
Commercialized
JAKAVI 15 MG COMPRIMIDOS
112773008
COMPRIMIDO
Diagnóstico Hospitalario
Commercialized
JAKAVI 20 MG COMPRIMIDOS
112773011
COMPRIMIDO
Diagnóstico Hospitalario
Commercialized

Philippines FDA Drug Approvals

Approved Product
Company
License Number
Dosage Form
Strength
Approval Date
No Philippines FDA approvals found for this drug.

Saudi SFDA Drug Approvals

Approved Product
Company
License Number
Dosage Form
Strength
Approval Date
No Saudi SFDA approvals found for this drug.

Malaysia NPRA Drug Approvals

Approved Product
Company
Registration Number
Dosage Form
Strength
Approval Date
No Malaysia NPRA approvals found for this drug.

UK EMC Drug Information

Medicine Name
MA Holder
MA Number
Pharmaceutical Form
Active Ingredient
Authorization Date
No UK EMC drug information found for this drug.

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