Key points for drug monitoring of Molotinib in bone marrow fibrosis

　　Momelotinib(brand name Ojjaara in some markets)is an oral JAK1/JAK2/ACVR1 inhibitor indicated for intermediate-or high-risk myelofibrosis with anemia in adults,including primary myelofibrosis and myelofibrosis secondary to polycythemia vera or essential thrombocythemia.It addresses anemia,splenomegaly and disease-related symptoms,but patient selection should consider platelet count,liver function,prior JAK inhibitor exposure and transfusion needs.

　　The usual recommended regimen is 200mg orally once daily,with or without food,swallowed whole.Severe hepatic impairment may require a lower starting dose;mild-to-moderate hepatic impairment and dose modification must be managed by a hematologist.Baseline and periodic monitoring should include complete blood count,platelets and liver biochemistry.Repeated anemia worsening,cytopenias,infection signs,bleeding,persistent gastrointestinal symptoms or fatigue require prompt reevaluation.Spleen status can be tracked by physical examination plus ultrasound or MRI volumetry,and symptom scales can record night sweats,abdominal fullness,bone pain and early satiety.