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Emapalumab + ruxolitinib is a combination therapy being investigated for the treatment of hemophagocytic lymphohistiocytosis (HLH). Emapalumab is a fully human IgG1 monoclonal antibody that binds to and neutralizes interferon-gamma (IFN-γ), a key driver of HLH pathogenesis. Ruxolitinib is a small molecule inhibitor of Janus kinase 1 (JAK1) and Janus kinase 2 (JAK2), which mediates signaling downstream of various pro-inflammatory cytokines, including IFN-γ. By combining these two agents, the regimen aims to provide a dual-pronged approach: emapalumab directly blocks the IFN-γ protein, while ruxolitinib inhibits the signaling pathways activated by residual IFN-γ and other cytokines involved in the "cytokine storm" characteristic of HLH. This specific dose-modified regimen is being evaluated in Phase III clinical trials led by The First Affiliated Hospital of Soochow University to improve efficacy and safety in patients with active, relapsed, or refractory HLH.
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