Would you like to take some more ruxolitinib after your fedratinib?

In Europe, ruxolitinib and fedratinib are the only JAK2 inhibitors available in local pharmacies. According to trial data, myelofibrosis patients should mostly receive ruxolitinib as first-line treatment and fedratinib in case of failure or intolerance (depending on their profile). Is it possible to reverse the choice of these drugs? Commentary on: Palandri et al. Ruxolitinib after Fedratinib failure in patients with myelofibrosis: a real-world case series. Br J Haematol 2024; 205:1605-1609.