COMMANDS Data Further Support Luspatercept as Preferred Anemia Treatment in MDS

By Patrick Daly - Last Updated: June 27, 2024

Compared with epoetin alfa, treatment with luspatercept more frequently yielded improvements in anemia measures for erythropoiesis-stimulating agent (ESA)-naïve patients with transfusion-dependent lower-risk myelodysplastic syndromes (MDS), according to authors of the COMMANDS study.

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The COMMANDS analysis findings at the data cutoff of March 31, 2023, were presented at the European Hematology Association 2024 Hybrid Congress in Madrid, Spain, by Valeria Santini, MD, of the University of Florence in Italy.

“A significantly greater proportion of patients treated with luspatercept than with epoetin alfa achieved improvements in hemoglobin levels, reductions in transfusion burden and red blood cell units transfused, and had durable red blood cell transfusion independence responses,” Dr. Santini reported.

Specifically, among patients treated for 12 or more weeks, Dr. Santini and colleagues observed 50% or greater reductions in red blood cell units transfused for 151 of 182 (83.0%) patients treated with luspatercept, with a median treatment duration of 130 weeks (95% CI, 120.6-not evaluable), versus 121 of 181 (66.9%) patients treated with epoetin alfa, with a median treatment duration of 77 weeks (95% CI, 54.9-123.1; P=.0002).

Luspatercept was favored over epoetin alfa in a proportion of patients with 50% or greater reductions in red blood cell units transfused after 12 weeks of treatment, regardless of baseline transfusion burden. Luspatercept was also favored after 24 weeks of treatment (P<.0001).

The median number of red blood cell units transfused from week one to week 24 of treatment was 1 (interquartile range [IQR], 0-5) in the luspatercept group compared with 3 (IQR, 0-8) in the epoetin alfa group. The median time to first transfusion was 155 days (IQR, 80-266) with luspatercept versus 42 days (IQR, 23-55) with epoetin alfa (P<.0001).

Overall, “luspatercept provided clinically meaningful outcomes, supporting its use as the preferred treatment for ESA-naïve patients with lower-risk MDS-associated anemia,” Dr. Santini summarized.

 

Reference

Santini V, Zeidan AM, Platzbecker U, et al. Clinical benefit of luspatercept in transfusion-dependent, erythropoiesis-stimulating agent-naive patients with very low-, low- or intermediate-risk myelodysplastic syndromes in the COMMANDS trial. Poster #P785. Presented at the European Hematology Association 2024 Hybrid Congress. June 13-16, 2024; Madrid, Spain.

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