A step forward in the treatment of myelofibrosis Learn more about the first and only medication proven to specifically treat intermediate or high-risk myelofibrosis Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. www.jakafi.com Jakafi® is a prescription medicine used to treat people with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post–polycythemia vera myelofibrosis, and post–essential thrombocythemia myelofibrosis. Table of contents Since I started on Jakafi, my spleen is significantly reduced, and I‘ve noticed a decrease in my symptoms. —Dan Living with myelofibrosis since 2009 Living with myelofibrosis .........................................................4 What is myelofibrosis?.............................................................6 Signs and symptoms of myelofibrosis.....................................8 Possible causes of myelofibrosis ........................................... 10 How does Jakafi work?.......................................................... 13 What are the possible benefits of Jakafi?.............................. 14 Important Safety Information on Jakafi ................................. 18 What are the side effects of taking Jakafi?............................20 How do I take Jakafi?.............................................................22 What to expect while taking Jakafi........................................24 How can I take an active role in my treatment?.....................26 Glossary.................................................................................28 Notes .....................................................................................31 The core symptoms studied with Jakafi were abdominal discomfort, early feeling of fullness, pain under the left ribs, itching, night sweats, and bone/muscle pain. Individual results may vary. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 2 www.jakafi.com Living with intermediate or high-risk myelofibrosis If you or someone close to you has been diagnosed with intermediate or high-risk myelofibrosis (MY-ah-lo-fye-BRO-sis), know that you are not alone. There are thousands of people living with this disease, and now there is a medication available that has been proven to specifically treat this condition. This guide was written to help you understand more about this condition and treatment with Jakafi (JAK-ah-fye). You will find information on these topics, as well as a list of helpful resources. This guide will also provide you with tips on how to talk to your doctor about managing your condition while taking Jakafi. Not actual patients. It is not known if Jakafi is safe or effective in children. It is not indicated for children. Jakafi is an oral prescription medicine used to treat people with intermediate or high-risk myelofibrosis. If you have intermediate or high-risk myelofibrosis, it means that you have 1 or more of these risk factors: Age greater than 65 Elevated blasts Presence of certain symptoms (undeveloped blood cells) Anemia Platelets below a certain level Elevated white blood cells Need for blood transfusions 4 www.jakafi.com Before and during treatment, it is important to take an active role in your care. Learning more about your condition and asking questions will help you make the most of treatment with Jakafi. You will notice that some words are green and bold within this brochure. These terms are explained in the glossary (pages 28 to 30). Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Myelofibrosis is a bone marrow condition that is part of a group of diseases called “myeloproliferative neoplasms“ (MY-ah-lo-pro-LIF-er-uh-tiv NEE-o-plaz-uhms). Myelofibrosis is also known as a bone marrow cancer or blood cancer. Your doctor may or may not have called myelofibrosis a cancer. We understand that hearing the word “cancer“may be scary, so it is important to remember that the seriousness of each person’s condition is different. Be sure to speak to your doctor about your specific case. On pages 26 and 27, you will find helpful tips for talking to your doctor. How myelofibrosis develops Bone marrow is where blood cells are made. People with myelofibrosis have a defect in their bone marrow that causes an imbalance of blood cells (too many or too few). Generally, people with myelofibrosis have too many or too few Red blood cells White blood cells Platelets An imbalance of these blood cells may cause symptoms and complications. Enlarged spleen and other symptoms Myelofibrosis can cause an enlarged spleen and various symptoms. Some other symptoms you may or may not recognize as related to myelofibrosis include abdominal discomfort, early feeling of fullness, pain under left ribs, itching, night sweats, and bone/muscle pain. These symptoms will be discussed in more detail on pages 8 and 9. 6 www.jakafi.com These are not all of the symptoms of myelofibrosis. Please talk to your doctor about any symptoms you are having. Myelofibrosis can also lead to serious complications, such as blood clotting, bleeding, and infection. Facts about myelofibrosis Myelofibrosis is 1 of a group of disorders called ”myeloproliferative neoplasms,” also known as MPNs Myelofibrosis is sometimes a person’s first MPN. This is called ”primary myelofibrosis” – In other cases, it can develop from other MPNs, such as polycythemia vera (PV) or essential thrombocythemia (ET) Depending on your risk factors for myelofibrosis, your doctor will consider your condition to be low, intermediate, or high risk Myelofibrosis is the rarest and most serious MPN – Approximately 16,000 to 18,500 people in the United States are diagnosed with myelofibrosis – It is estimated that 80% to 90% of people with myelofibrosis have intermediate or high-risk myelofibrosis Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Understanding Myelofibrosis What is myelofibrosis? Understanding Myelofibrosis Signs and symptoms of myelofibrosis New blood cells are usually made in the bone marrow. But because the bone marrow does not work as it should in people with myelofibrosis, the spleen also makes new blood cells and stores many of them. This can cause the spleen to get bigger. People with myelofibrosis may also have other symptoms, such as Itching Night sweats Bone/muscle pain Many people with myelofibrosis have an enlarged spleen. This is a key sign of the disease. It is important to tell your doctor about any symptoms you are having, even if they do not bother you. There may be a treatment that can help. Spleen growth varies in people with myelofibrosis, but any degree of spleen growth is not normal. Spleen size is known to increase over time in people with myelofibrosis. spleen As the spleen makes new blood cells, it can continue to grow in size, as seen in the picture above. An enlarged spleen can cause symptoms, such as Abdominal discomfort Early feeling of fullness Pain under the left ribs 8 www.jakafi.com How myelofibrosis can change over time Myelofibrosis is a chronic condition, meaning it lasts a long time and does not go away, and there are many things that can affect the course of your disease. There are different factors that your doctor may use to determine your disease outlook. You are considered to have intermediate or high-risk myelofibrosis if you have or have had 1 or more of these risk factors at any time: Age greater than 65, presence of certain symptoms, anemia, elevated white blood cells, elevated blasts, platelets below a certain level, or a need for blood transfusions unrelated to drug therapy. Myelofibrosis develops differently in each person. In some people, the disease can get worse over time and can lead to a more enlarged spleen and more severe symptoms. Therefore, it is important to speak to your doctor about the severity of your disease and which treatment may be right for you. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Possible causes of myelofibrosis Myelofibrosis is a complex condition, and researchers are still trying to discover its exact cause. However, these researchers now think that 1 cause is when proteins that communicate within blood cells send too many messages. These proteins are called “JAKs“ (Janus kinases), and the messages they send are called “signals.” When they are signaling normally, JAKs help your body make the right number of blood cells. When JAKs send too many signals, they cause the body to make the wrong number of blood cells. This chain of events is called “overactive JAK signaling.” A JAK2 mutation is present in about 50% to 60% of people with myelofibrosis. Because of this, your doctor may test to see if you have a JAK2 mutation. This can help him or her confirm a diagnosis of myelofibrosis. Overactive JAK signaling in the blood-forming cells Cell membrane Having the wrong number of blood cells may lead to increased blood clotting, bleeding, anemia, or an increased risk of infection. Overactive signaling Overactive JAK signaling may also lead to an enlarged spleen and myelofibrosis symptoms.* JAK How JAK signaling can become overactive JAK signaling can become overactive in many ways. One of these ways is by a JAK2 mutation. However, even people without a JAK2 mutation are believed to have overactive JAK signaling. *The core symptoms studied with Jakafi were abdominal discomfort, early feeling of fullness, pain under the left ribs, itching, night sweats, and bone/muscle pain. 10 www.jakafi.com All people with myelofibrosis are believed to have overactive JAK signaling, even if they do not have a JAK2 mutation. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Jakafi is the first and only medication approved to treat intermediate or high-risk myelofibrosis It is not known if Jakafi is safe or effective in children. It is not indicated for children. Indication Jakafi is a prescription medicine used to treat people with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post–polycythemia vera myelofibrosis, and post–essential thrombocythemia myelofibrosis. Jakafi can cause serious side effects including: Low blood counts: Jakafi may cause your platelet, red blood cell, or white blood cell counts to be lowered. Tell your healthcare provider right away if you experience unusual bleeding, bruising, fatigue, shortness of breath, or a fever. Your healthcare provider will perform blood tests to check your blood counts before you start Jakafi and regularly during your treatment. Your healthcare provider may change your dose of Jakafi or stop your treatment based on the results of your blood tests. 12 www.jakafi.com Jakafi is designed to target JAKs (Janus kinases). By doing so, Jakafi decreases overactive JAK signaling. Jakafi works in different types of myelofibrosis. It was studied in people With or without a JAK2 mutation With primary myelofibrosis With secondary myelofibrosis (post–polycythemia vera myelofibrosis or post–essential thrombocythemia myelofibrosis) A new era in myelofibrosis treatment Before Jakafi, no therapies were approved to specifically treat myelofibrosis. Instead, doctors used medicines approved for other diseases to try and help control the signs and symptoms of myelofibrosis. With Jakafi, a medication is available that is approved to specifically treat intermediate or high-risk myelofibrosis by targeting JAKs. In 1 study, close to half (42%) of all people taking Jakafi had a 35% or greater reduction in spleen size. Also in that study, almost half (46%) of people taking Jakafi had their Total Symptom Score (TSS) improved by 50% or more. The TSS represents a group of symptoms that were measured over a 6-month period and consisted of abdominal discomfort, early feeling of fullness, pain under the left ribs, itching, night sweats, and bone/muscle pain. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Treatment With Jakafi Not actual patients. How does Jakafi (JAK-ah-fye) work? Treatment With Jakafi What are the possible benefits of Jakafi? Jakafi has been studied in more than 300 people with intermediate or high-risk myelofibrosis. These studies were designed to see if Jakafi helped reduce spleen size and improve symptoms. The core symptoms studied with Jakafi were abdominal discomfort, early feeling of fullness, pain under the left ribs, itching, night sweats, and bone/muscle pain. Jakafi was tested in 2 separate studies against placebo (sugar pill) and other medicines, such as hydroxyurea and glucocorticoids. Jakafi can cause serious side effects including Infection: You may be at risk for developing a serious infection while taking Jakafi. Tell your healthcare provider if you develop symptoms such as chills, nausea, vomiting, aches, weakness, fever, or painful skin rash or blisters. Jakafi provided reductions in spleen size Jakafi in people with anemia Overall, more people in the study taking Jakafi required red blood cell transfusions than people taking placebo. Spleen size before Jakafi Reduced spleen size with Jakafi Jakafi may be prescribed in people who test positive or negative for a JAK2 mutation. In this study, people who developed anemia while taking Jakafi experienced reductions in spleen size and improvements in symptoms that were similar to people who did not develop anemia while on therapy. The change in spleen size shown is based on the results of a study that looked at spleen size before people took Jakafi and again 6 months after starting Jakafi. The study assessed whether a person had at least a 35% reduction in spleen size. Individual results may vary. Spleen size is known to increase in people with myelofibrosis. In 2 studies, people taking Jakafi had a greater reduction in spleen size compared with people who did not take this treatment. 14 www.jakafi.com On average, when treatment was started with Jakafi, people‘s hemoglobin levels lowered. After several weeks of continued treatment, hemoglobin gradually increased to a new, steady level that was still lower than at the beginning of treatment. On page 20, you will find more information about possible blood-related side effects with Jakafi. You should discuss these side effects with your healthcare provider to help understand what they may mean to your specific condition. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Jakafi provided improvements in myelofibrosis symptoms Symptoms are known to get worse in people with myelofibrosis. Researchers measured the effect Jakafi had on the following core symptoms, which, when combined, make up the Total Symptom Score (TSS): Spleen-related Abdominal discomfort Early feeling of fullness Pain under the left ribs Non–spleen-related Some of the side effects with Jakafi Common side effects seen with Jakafi are dizziness and headache. These are not all the possible side effects of Jakafi. Ask your healthcare provider or pharmacist for more information. Tell your healthcare provider about any side effect that bothers you or that does not go away. Itching Night sweats Bone/muscle pain When combined, improvements in each of these symptoms led to a better TSS in people taking Jakafi, compared with people not taking Jakafi. Almost half of people taking Jakafi had their group of symptoms improve by 50% or more over a 6-month period. In people who did not take Jakafi, these symptoms often got worse. If you experience blood-related side effects, your doctor may have to raise or lower your dose of Jakafi or temporarily stop your treatment. “I didn't know what was causing some of my symptoms. My doctor told me that my early feeling of fullness, itching, night sweats, and bone/muscle pain may be caused by myelofibrosis.” —Susan Living with myelofibrosis Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 16 www.jakafi.com Important Safety Information on Jakafi Infection: You may be at risk for developing a serious infection while taking Jakafi. Tell your healthcare provider if you develop symptoms such as chills, nausea, vomiting, aches, weakness, fever, or painful skin rash or blisters. The most common side effects of Jakafi include dizziness and headache. These are not all the possible side effects of Jakafi. Ask your healthcare provider or pharmacist for more information. Tell your healthcare provider about any side effect that bothers you or that does not go away. Jakafi can cause serious side effects including: Low blood counts: Jakafi may cause your platelet, red blood cell, or white blood cell counts to be lowered. Tell your healthcare provider right away if you experience unusual bleeding, bruising, fatigue, shortness of breath, or a fever. Your healthcare provider will perform blood tests to check your blood counts before you start Jakafi and regularly during your treatment. Your healthcare provider may change your dose of Jakafi or stop your treatment based on the results of your blood tests. Before taking Jakafi, tell your healthcare provider about all the medications, vitamins, and herbal supplements you are taking and all your medical conditions, including if you have an infection, have or had liver or kidney problems, are on dialysis, or have any other medical condition. Talk to your healthcare provider before drinking grapefruit juice while taking Jakafi. Women should not take Jakafi while pregnant or planning to become pregnant, or if breast-feeding. Please see accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 18 www.jakafi.com Side Effects With Jakafi Not actual patient. What are the side effects of taking Jakafi? Possible blood-related side effects Jakafi works in blood cells by targeting JAKs (Janus kinases), which control blood production. In people with myelofibrosis, JAKs become overactive, sending too many signals. While Jakafi reduces overactive JAK signaling, it may also cause certain blood counts to become lower. Because of this, your doctor will continue to check your blood counts to evaluate any blood-related side effects, such as Side Effects With Jakafi Thrombocytopenia (throm-bo-sye-toe-PEE-nee-uh): A condition in which a person has a low number of platelets. This may cause problems with blood clotting, including bruising and bleeding Anemia (uh-NEE-mee-uh): A condition in which a person has a low number of red blood cells. This may cause tiredness (fatigue), a feeling of weakness, and shortness of breath Neutropenia (new-truh-PEE-nee-uh): A condition in which a person has a low number of white blood cells. Neutropenia may increase the risk for infections In studies, blood-related side effects caused 1% or less of people to stop treatment. If you experience any of these side effects, your doctor may have to raise or lower your dose of Jakafi or temporarily stop your treatment. Possible non–blood-related side effects In a study, non–blood-related side effects experienced by people taking Jakafi included bruising, dizziness, and headache. Some people in the study stopped treatment. A similar percentage of people (about 11%) stopped their treatment whether they were taking Jakafi or placebo. These are not all of the possible side effects associated with Jakafi. Ask your healthcare team for more information. Tell your doctor about any side effects you experience while taking Jakafi. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 20 www.jakafi.com How do I take Jakafi? Take Jakafi twice a day as directed by your doctor Jakafi is a pill that you take twice a day, at about the same time each day. You can take Jakafi with or without food. If you miss a dose, take your next one as scheduled. Do not take an additional dose. Before taking Jakafi Before taking Jakafi, tell your healthcare provider about all the medications, vitamins, and herbal supplements you are taking. Especially tell your doctor if you take medicine for fungal infections, bacterial infections, or HIV/AIDS. Also tell your doctor about all of your medical conditions, including if you have an infection, have or have had liver or kidney problems, or are on dialysis. Jakafi should be taken after your dialysis. Tell your doctor if you have any other medical conditions. Talk to your healthcare provider before drinking grapefruit juice while taking Jakafi. Women should not take Jakafi while pregnant or planning to become pregnant, or if breast-feeding. Bottles and tablets shown are not actual size and are not proportional to each other. If you take too much Jakafi, call your healthcare provider or go to the nearest hospital emergency department right away. Take the bottle of Jakafi with you. Not actual patient. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 22 www.jakafi.com How to Take Jakafi There are different strengths of Jakafi: 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg. Make sure you take your dose exactly as your doctor prescribes. What to expect while taking Jakafi As mentioned earlier, Jakafi may cause certain blood counts to become lower. Therefore, your doctor will monitor your blood count levels while you are taking Jakafi. Before you begin treatment: Your doctor will perform a complete blood count (CBC). The results of your test will determine which dose of Jakafi is right for you. During treatment: Your doctor will check your blood cell counts regularly to make sure they don’t become too low. Why is it important to keep taking Jakafi? Even if you start feeling better, you should still continue to take Jakafi as your doctor prescribes. Once treatment with Jakafi stops, the spleen is expected to get bigger again and symptoms are expected to return in as little as 1 week. If you are having any side effects, tell your doctor. Do not stop taking Jakafi without speaking to him or her first. Depending on how you’re responding to Jakafi: Your doctor may raise or lower your dose to help maintain appropriate blood count levels and/or treat your condition. In some instances, your doctor may have to temporarily stop treatment with Jakafi. How to Take Jakafi Your doctor may tell you to stop taking Jakafi if, after 6 months, you don‘t see any reduction in spleen size or improvement in symptoms. If you can‘t take Jakafi by mouth: Jakafi may also be given through certain nasogastric tubes. A nasogastric tube delivers the medicine directly to your stomach. Your healthcare provider will decide if you can take Jakafi in this manner. Ask your healthcare provider to give you specific instructions on how to properly take Jakafi through a nasogastric tube. Take Jakafi twice a day as directed by your doctor It is important to continue taking Jakafi every day, just as your doctor prescribes. Jakafi is a long-term treatment. 24 www.jakafi.com It is important to stay on Jakafi as directed by your doctor, so he or she can best manage your condition. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. How can I take an active role in my treatment? Topics to discuss with your doctor There are many things you can learn about myelofibrosis and Jakafi. The more you know, the more you can play an active role in your care. One way you can take an active role is to set treatment goals. Discuss with your doctor what to expect while taking Jakafi, and make a plan for the future. Also, be sure to always keep an open dialogue with your doctor. Keep track of how you feel Always tell your doctor how you’re feeling. Be sure to report any new symptoms or current symptoms that may be getting worse. The only way your doctor can properly treat your disease is if he or she is fully aware of how you’re feeling. You can use the Notes section on page 31 to keep track of how you feel. Ask questions, such as How severe is my disease? What can I do to best manage my disease? Is Jakafi right for me? How long will I take Jakafi? How will I feel while taking Jakafi? What should I look out for when taking Jakafi? Are there any foods or medications that I should avoid while taking Jakafi? Not actual patient. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 26 www.jakafi.com Glossary Anemia: A condition in which a person has a low number of red blood cells. Blasts: Undeveloped, immature cells that develop into mature blood cells. Bone marrow: Where blood cells are made. Bone marrow is soft tissue found inside some bones, such as the hip and thigh bones, that contains immature cells called “stem cells.” These stem cells can develop into red blood cells, white blood cells, or platelets. Chronic: Conditions that last a long period of time. Complete blood count (CBC): A blood test that measures different cells and other elements in your blood. The results of a CBC give doctors a better picture of overall health. Essential thrombocythemia (ET): A disease in which the bone marrow produces too many platelets. Having too many platelets can cause symptoms and complications. People with ET often do not have symptoms. They may, however, be prone to blood clots and other complications. Hemoglobin: The part of the red blood cell that carries oxygen. Myeloproliferative neoplasms (MPNs): A group of blood conditions that involve an imbalance in the number of blood cells being made. Myelofibrosis (including primary myelofibrosis, post–polycythemia vera myelofibrosis, and post–essential thrombocythemia myelofibrosis), essential thrombocythemia, and polycythemia vera are MPNs. They are sometimes called blood cancers, bone marrow cancers, or bone marrow disorders (because blood cells are made in your bone marrow). Neutropenia: A condition in which a person has a low number of white blood cells. Platelets: Small cell fragments that help stop bleeding and aid in healing. Polycythemia vera (PV): A disease in which the bone marrow produces too many blood cells, especially red blood cells. These cells function normally, but there are too many of them. Platelets and white blood cells may also be overproduced. Post–essential thrombocythemia myelofibrosis: Myelofibrosis that develops from essential thrombocythemia. Post–polycythemia vera myelofibrosis: Myelofibrosis that develops from polycythemia vera. JAKs (Janus kinases): Proteins that exist in blood cells. Mutation: A small change in DNA that causes proteins to act differently than they are supposed to. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Glossary 28 www.jakafi.com Glossary (continued) Notes Primary myelofibrosis: Myelofibrosis that did not develop from either polycythemia vera or essential thrombocythemia. Please use this section to write down any questions or thoughts you may wish to share with your healthcare team. Proteins: Natural substances that exist in cells. Proteins are vital players in all of the cellular activities in the body. Red blood cells: Cells that deliver oxygen throughout the body. These cells also remove waste products from the body‘s tissues. Secondary myelofibrosis: Myelofibrosis that develops from polycythemia vera or essential thrombocythemia. Spleen: An organ located above your stomach and under the left ribs. It is approximately the size of a fist. The spleen fights infection and stores red blood cells and platelets. The spleen filters blood, destroys old and damaged cells, and contains white blood cells that fight germs. Thrombocytopenia: A condition in which a person has a low number of platelets. White blood cells: Blood cells that help fight infection. Glossary Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. 30 www.jakafi.com A step forward in the treatment of myelofibrosis Myelofibrosis is a serious chronic condition that develops from a defect in the bone marrow. Myelofibrosis can cause an enlarged spleen and various symptoms. There may be a treatment that can help. Jakafi is the first and only prescription medication proven to specifically treat intermediate or high-risk myelofibrosis. Jakafi reduces the enlarged spleen and helps improve the symptoms* of myelofibrosis Jakafi can cause serious side effects, including low blood counts and an increased risk of infection. In a study, non–blood-related side effects were usually mild and included bruising, dizziness, and headache Visit www.jakafi.com/brochure for more information on Jakafi and myelofibrosis, plus valuable educational resources. Visit www.IncyteCARES.com or call 1-855-4-Jakafi (855-452-5234) to get connected to support from Incyte. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. *People taking Jakafi had an improvement in a group of symptoms. The group of symptoms that Jakafi has been proven to improve is abdominal discomfort, early feeling of fullness, pain under the left ribs, itching, night sweats, and bone/muscle pain. Please see Important Safety Information on pages 18 and 19 and accompanying Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi. Jakafi is a registered trademark of Incyte Corporation. © 2012, Incyte Corporation. All rights reserved. RUX-1013 06/12
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