Table 4.

Novel medications for β-thalassemia

MedicationMechanism of actionRoute and frequency of administrationPhase of developmentCurrent target patient populationIn development for sickle cell disease?Comments
Luspatercept1,5  TGF-β inhibitor Subcutaneous, every 3 weeks EMA and FDA approved NTDT, TDT No Full data for NTDT pending; in use for MDS 
Sotatercept36,37  TGF-β inhibitor Subcutaneous, every 3 weeks Development halted NTDT, TDT No In development for pulmonary hypertension 
Sirolimus25-28  mTOR inhibitor; HbF induction Oral, daily Phase 2 trials TDT No In use for other disorders 
Benserazide31,32  HbF induction Oral, daily Phase 1 trial NTDT Yes In use for Parkinson disease 
IMR-68729,30  PDE-9 inhibitor; HbF induction Oral, daily Phase 2 trial NTDT, TDT Yes  
Apotransferrin19-21  Hepcidin upregulation Intravenous, every 2 weeks Phase 2 trial NTDT No  
VIT-276322  Ferroportin inhibitor Oral, one or twice daily Phase 2 trial NTDT Yes  
PTG-30023  Hepcidin mimetic Subcutaneous, once weekly Phase 2 trials NTDT, TDT No In development for hemochromatosis and polycythemia vera 
Mitapivat33-35  Pyruvate kinase activator Oral, twice daily Phase 3 trials NTDT, TDT Yes In development for pyruvate kinase deficiency 
Ruxolitinib38  JAK 1/2 inhibitor Oral, twice daily Development halted TDT No Spleen size reduction; no change in transfusion 
MedicationMechanism of actionRoute and frequency of administrationPhase of developmentCurrent target patient populationIn development for sickle cell disease?Comments
Luspatercept1,5  TGF-β inhibitor Subcutaneous, every 3 weeks EMA and FDA approved NTDT, TDT No Full data for NTDT pending; in use for MDS 
Sotatercept36,37  TGF-β inhibitor Subcutaneous, every 3 weeks Development halted NTDT, TDT No In development for pulmonary hypertension 
Sirolimus25-28  mTOR inhibitor; HbF induction Oral, daily Phase 2 trials TDT No In use for other disorders 
Benserazide31,32  HbF induction Oral, daily Phase 1 trial NTDT Yes In use for Parkinson disease 
IMR-68729,30  PDE-9 inhibitor; HbF induction Oral, daily Phase 2 trial NTDT, TDT Yes  
Apotransferrin19-21  Hepcidin upregulation Intravenous, every 2 weeks Phase 2 trial NTDT No  
VIT-276322  Ferroportin inhibitor Oral, one or twice daily Phase 2 trial NTDT Yes  
PTG-30023  Hepcidin mimetic Subcutaneous, once weekly Phase 2 trials NTDT, TDT No In development for hemochromatosis and polycythemia vera 
Mitapivat33-35  Pyruvate kinase activator Oral, twice daily Phase 3 trials NTDT, TDT Yes In development for pyruvate kinase deficiency 
Ruxolitinib38  JAK 1/2 inhibitor Oral, twice daily Development halted TDT No Spleen size reduction; no change in transfusion 

EMA, European Medicines Agency; FDA, Food and Drug Administration; JAK, Janus-associated kinase; MDS, myelodysplastic syndrome; mTOR, mechanistic target of rapamycin.