ClinicalTrials.gg
RecruitingNCT04116502MITHRIDATEUpdated Oct 26, 2026

MITHRIDATE: Ruxolitinib Versus Hydroxycarbamide or Interferon as First Line Therapy in High Risk Polycythemia Vera

A Phase 3 interventional study of Ruxolitinib and Hydroxycarbamide in Polycythemia Vera, sponsored by University of Birmingham. Recruiting at 55 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-26.

Sponsored by University of Birmingham · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2019; still recruiting 7 years later.
Updated Oct 26, 2026Study contact changed8 sites addedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
586
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The trial will be a phase III, randomised-controlled, multi-centre, international, open-label trial consisting of ruxolitinib versus best available therapy, where best available therapy is a choice of interferon alpha, any formulation permitted (IFN) or hydroxycarbamide (HC), and which will be elected by the Investigator prior to randomisation.

Read the detailed description

The trial will be a phase III, randomised-controlled, multi-centre, international, open-label trial consisting of ruxolitinib versus best available therapy, where best available therapy is a choice of interferon alpha, any formulation permitted (IFN) or hydroxycarbamide (HC), and which will be elected by the Investigator prior to randomisation.

There will be no cross-over either between arm A and B or between therapies on Arm B

HC and IFN will be provided as best available therapy, IFN can include standard of pegylated-interferon at Investigators discretion.

02

Conditions studied

  • Polycythemia Vera

Browse trials for

03

In context

Polycythemia Vera

278 studies on the registry are indexed under Polycythemia Vera; 53 are open to participants now.

This study's planned enrollment of 586 is above the median of 52 across 204 interventional studies indexed under Polycythemia Vera.

Browse Polycythemia Vera studies →

Lead sponsor

University of Birmingham is the lead sponsor of 182 studies on the registry; 29 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Population:

High risk PV defined as WBC >11 x 10\^9/l* AND at least ONE of the following

  • Age >60 years
  • Prior thrombosis or haemorrhage
  • count >1000 x 10\^9/l*
  • Hypertension or diabetes requiring pharmacological therapy (*At any time since diagnosis)

Inclusion criteria

Inclusion Criteria:

  1. Patient ≥18 years of age
  2. Diagnosis of PV meeting the WHO criteria within the past 15 years
  3. Meets criteria of high risk* PV (see above for specific population)
  4. Patients must have a screening of >8g/dl
  5. Patients may have received antiplatelet agents and venesection
  6. Patients may have received ONE cytoreductive therapy for PV less than 10 years (BUT they should not be resistant or intolerant to that therapy)
  7. Able to provide written

Exclusion criteria

Exclusion Criteria:

  1. Diagnosis of PV > 15 years previously
  2. Absence of JAK-2 mutation
  3. Patients with any to any of the medical products
  4. Treatment with >1 cytoreductive therapy OR a cytoreductive treatment duration exceeding 10 years OR resistance/intolerance to that therapy
  5. Active infection including (HIV), , , hepatitis, Tuberculosis
  6. Pregnant or lactating patients (Women of must have a negative urine or blood Human Chorionic Gonadotropin pregnancy test prior to trial entry)
  7. Patients with lactose allergies, , or rare hereditary problems, of galactose intolerance, total lactase deficiency or glucose- galactose malabsorption
  8. Patients with uncontrolled neuropsychiatric disorders
  9. Patients with uncontrolled cutaneous cancers
  10. Patients and partners not prepared to adopt highly effective measures (if sexually active) whilst on treatment and for at least 6 months after completion of study medication
  11. Performance Status Score ≥ 3
  12. Uncontrolled rapid or paroxysmal atrial fibrillation, uncontrolled or unstable angina, recent (within the last 6 months) myocardial infarction or acute coronary syndrome or any cardiac disease > ( New York Heart Association) Class II
  13. Patients who have transformed to myelofibrosis
  14. Previous treatment with ruxolitinib
  15. Previous (within the last 12 months) or current count \<100 x 109/L or \< 1 x 109/L not due to therapy
  16. Inadequate liver function as defined by /AST >2.0 x
  17. Inadequate renal function as defined by \< 30 mls/min
  18. Unable to give

    Additional Exclusion Criteria for France Only

  19. All women of childbearing potential (as per Appendix 8 definition)
  20. No affiliation with the French healthcare system
  21. Persons under psychiatric care that would impede understanding of informed consent and optimal treatment and follow-up
  22. Adults subject to a legal protection measure (guardianship, curatorship and safeguard of justice)
  23. Patients deprived of their liberty by a judicial or administrative decision
Terms in these criteria, in plain language(19)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
586 participants (estimated)

Study arms

  • Experimental
    A- Ruxolitinib

    Treatment with Ruxolitinib

    Drug: Ruxolitinib

  • Active comparator
    B- Hydroxycarbamide OR Interferon A

    Best Available Therapy (BAT), Treatment with hydroxycarbamide OR Interferon A

    Drug: Hydroxycarbamide · Drug: Interferon-Alpha

Interventions

  • 10mg of ruxolitinib twice daily (bd)

    Also known as: Jakavi®

  • Via standard hospital mechanisms

    Also known as: Hydroxyurea

  • Any formulation, via standard hospital mechanisms

    Also known as: Interferon, alpha interferon, Intron® A, Roferon® A

06

What researchers measure

Primary outcomes

  1. Event Free Survival (EFS)

    Event Free Survival

    Time frame: the time from randomisation to the date of the first major thrombosis/haemorrhage, death,transformation to Myelodysplastic Syndromes, Acute Myeloid Leukaemia or Post-polycythemia Vera Myelofibrosis, if within the ~3 year trial period

Secondary outcomes

  1. Major thrombosis

    As defined in the protocol, combined and split to venous and arterial

    Time frame: Occurring while on treatment (over 3 years)

  2. Major haemorrhage

    As defined in the protocol

    Time frame: Occurring while on treatment (over 3 years)

  3. Transformation to PPV-MF

    Transformation to PPV-MF

    Time frame: Occurring while on treatment (over 3 years)

  4. Transformation to MDS and/or AML

    Transformation to MDS and/or AML

    Time frame: Occurring while on treatment (over 3 years)

  5. Complete Haematological remission (CHR)

    As defined by ELN response criteria at 1 year

    Time frame: 1 year post-treatment

  6. Symptom burden/Quality of life (MPN-SAF)

    As measured via MPN-SAF

    Time frame: Questionnaires collected at baseline, weeks 12, 26, 39, 55, months 15, 18, 24, 30 and 36

  7. Symptom burden/Quality of life (MDASI)

    As measured via MDASI

    Time frame: Questionnaires collected at baseline, weeks 12, 26, 39, 55, months 15, 18, 24, 30 and 36

  8. Symptom burden/Quality of life (EQ-5D)

    As measured via EQ-5D

    Time frame: Questionnaires collected at baseline, weeks 12, 26, 39, 55, months 15, 18, 24, 30 and 36

  9. Health economics

    Including cost utility and cost effectiveness analyses as defined by the protocol (e.g. QALYs)

    Time frame: At the end of the trial (trial duration of approximately 8 years)

  10. Peripheral blood JAK2 V617F allele burden

    According to ELN response criteria

    Time frame: At baseline and annually throughout the trial (from baseline until approximately 3 years post-randomisation)

  11. Rates of discontinuation

    Trial discontinuation

    Time frame: From treatment prior to protocol defined 3 years

  12. Rate and severity of adverse events

    collected according to CTCAE version 4.0 and the MITHRIDATE protocol

    Time frame: Continuous throughout the trial (from randomisation until approximately 3 years post-randomisation))

  13. Spleen response

    in patients with splenomegaly

    Time frame: Response at 1 year post randomisation

  14. Time free from venesection

    Time free from venesection

    Time frame: Defined as the mean time between venesections while on trial treatment (treatment duration of 3 years)

  15. Secondary malignancy

    Malignancy independent to the original diagnosis

    Time frame: Occurring throughout the trial (from randomisation until approximately 3 years post-randomisation)

  16. Change in QRisk score

    Change in QRisk score

    Time frame: Collected at baseline and years 1, 2 and 3

Other outcomes

  1. Progression of marrow fibrosis

    Progression of marrow fibrosis (bone marrow collected and analysed at the Weatherall Institute of Molecular Medicine (WIMM) in Oxford

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  2. Impact of treatment on molecular signatures of disease

    Impact of treatment on molecular signatures of disease (as analysed by the WIMM in Oxford)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  3. Clonal involvement

    within the stem/progenitor cell compartment (as analysed by the WIMM in Oxford)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  4. Clonal evolution

    (acquisition of additional mutations, as analysed by the WIMM in Oxford)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  5. Reduction of peripheral blood allele burden

    of other disease-association mutations (as analysed by the WIMM in Oxford)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  6. Assessment of the prevalence of clonality markers for haematological disease

    and any change over time (as analysed by the WIMM in Oxford)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  7. Cardiac event

    (angina, acute coronary syndrome, acute MI; arrhythmia)

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  8. Pulmonary hypertension

    Pulmonary hypertension as assessed clinically

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  9. Coronary intervention

    e.g. angiogram, angioplasty, CABG

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  10. Deterioration in cardiac function

    e.g. LVEF% on ECHO/MUGA and/or NYHA classification

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  11. Cerebrovascular event

    TIA, haemorrhagic CVA, non-haemorrhagic CVA

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  12. Arterial vascular event

    peripheral vascular disease: claudication, carotid stenosis

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  13. Venous thrombosis

    including DVT, PE, Cerebral, splanchnic, other

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  14. Pregnancy loss

    Pregnancy loss

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

  15. Thrombosis biomarkers

    Correlation of thrombosis biomarkers with clinical thrombosis events

    Time frame: Occurring throughout the trial (from randomisation to approximately 3 years post-randomisation)

07

Study locations

53 of 55 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Sites
8 sites added
Show 8 added (8 United Kingdom)
  • Glan Clwyd Hospital · Bodelwyddan, United Kingdom
  • University Hospital · Coventry, United Kingdom
  • Ipswich Hospital · Ipswich, United Kingdom
  • St James's University Hospital · Leeds, United Kingdom
  • George Eliot Hospital · Nuneaton, United Kingdom
  • Derriford Hospital · Plymouth, United Kingdom
  • Royal Hallamshire Hospital · Sheffield, United Kingdom
  • York Hospital · York, United Kingdom
Oct 26, 2026
Contact
Study contact changed: m•••@trials.bham.ac.uk · •••2535→m•••@trials.bham.ac.uk · •••2535. See the current contact
Oct 26, 2026
Show all 1 update
  1. Oct 26, 2026
    8 sites added
    Show 8 added (8 United Kingdom)
    • Glan Clwyd Hospital · Bodelwyddan, United Kingdom
    • University Hospital · Coventry, United Kingdom
    • Ipswich Hospital · Ipswich, United Kingdom
    • St James's University Hospital · Leeds, United Kingdom
    • George Eliot Hospital · Nuneaton, United Kingdom
    • Derriford Hospital · Plymouth, United Kingdom
    • Royal Hallamshire Hospital · Sheffield, United Kingdom
    • York Hospital · York, United Kingdom
    Contact Study contact changed: m•••@trials.bham.ac.uk · •••2535→m•••@trials.bham.ac.uk · •••2535. See the current contact

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT04116502
Collaborators
Novartis, MPN Voice, National Cancer Institute, France
Responsible party
Sponsor
First posted
Oct 4, 2019
Start date
Oct 25, 2019
Primary completion
Oct 31, 2028 (estimated)
Completion
Apr 1, 2030 (estimated)
Last update
Oct 26, 2026

Study contacts

Natalia Morelli
Contact
mithridate@trials.bham.ac.uk
+44(0)121 414 2535
Claire Harrison
principal investigator · Acting on behalf of the Sponsor (UK), Guy's Hospital, London, UK, SE1 9RT
Jean-Jacques Kiladjian
principal investigator · (France) Clinical Investigations Center, Saint-Louis Hospital, Paris, France

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Ruxolitinib

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