Patient Introduction

Hello, my name is Jason, and I’m 57 years old. I was diagnosed with leukemia a year and a half ago and underwent chemotherapy. At first, it seemed to work, but then the cancer came back, so I received a stem cell transplant 4 months ago. My doctor put me on steroids right after, but then I started to develop a painful, rash on my back and arms and pain in my shoulder. My doctor increased my dosage, but it still didn’t seem to help, so I was put on another medication called ruxolitinib 2 months ago. The rash started to clear up just slightly with this new medication, but then started to get worse again a few days ago. I just want to find something that works for me.

Question #1

I understand your rash hasn’t improved with the medication you were given, Jason. Let’s discuss how you are feeling now. Do you have any ongoing symptoms like feeling dizzy or tired? Or any other symptoms that concern you?

Answer

Question #2

I see; the pre-visit forms you filled out also mentioned shoulder pain. Tell me more about this; has this pain affected your day-to-day activities?

Answer

Question #3

I’m sorry to hear that; I can see how that can be frustrating. Other than your current medication of ruxolitinib, are you taking anything else?

Answer

Question #4

Besides the rash and the shoulder pain we discussed, how have you been feeling since you’ve started taking ruxolitinib? Have you been evaluated or treated for any other conditions?

Answer

Question #5

It sounds like you may be experiencing some side effects. There are other treatment options we can consider, including one medication called belumosudil. It helps improve pain and inflammation. Has anyone discussed this medication with you before?

Answer

Question #6

There are side effects, such as cough and headache, but they are manageable. What are your thoughts on that?

Answer

Question #7

There are more options available for treatment, including two medications called axatilimab and ibrutinib. They work differently in the body and have their own side effects but can improve symptoms. Any preferences for taking medications?

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Question #8

There are treatment options that you can take by mouth at home. Our goal is to reduce inflammation in the body, which can affect your skin and organs, such as your liver or lungs, and cause those tissues to stiffen.

Answer

Question #9

Yes, this can happen after a stem cell transplant, and it’s called graft vs host disease. You’ve tried a few different therapies, including ruxolitinib, but haven’t improved, so the inflammation is becoming chronic, which can affect your physical quality of life.

Answer

Question #10

These medications target specific immune pathways affecting inflammation, which can reduce collagen deposits that cause stiffness. In fact, belumosudil had a 71% response rate for joint symptoms; some even responded within 5 weeks. Would you like to consider this?

Answer

This activity is provided by Med Learning Group.
This program is supported by an independent medical education grant from Sanofi US.
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