In Reply We thank Dr Suzuki and colleagues for their comments regarding our article. Their assumption regarding reduced incidence of herpes zoster infection in patients treated with pacritinib relative to ruxolitinib or other Janus kinase 1/2 inhibitors is borne out by the clinical data: the incidence of herpes zoster infection in the PERSIST-2 trial was 0%, 1%, and 1% in the pacritinib 200 mg twice daily, 400 mg once daily, and best available therapy arms, respectively (unpublished data, CTI BioPharma Corp, clinical study report for PERSIST-2 trial, November 2016). Although some patients in the best available therapy arm received ruxolitinib, their exposure was predominantly low dose and of short duration owing to the high crossover rate to pacritinib after 24 weeks. In the overall clinical trial experience with pacritinib in patients with myelofibrosis (n = 692), the incidence of herpes zoster infection was 0.6% with median pacritinib treatment of 8.3 months (maximum treatment, 3.3 years). The incidence of other opportunistic infections has been similarly low.
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