ClinicalTrials.gg
RecruitingNCT07098936Updated Aug 10, 2026

Momelotinib in VEXAS Syndrome

A Phase 2 interventional study of Momelotinib treatment in VEXAS Syndome and Myelo Dysplastic Syndrome, sponsored by Groupe Francophone des Myelodysplasies. Recruiting at 11 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-10.

Sponsored by Groupe Francophone des Myelodysplasies · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Nov 2025; still recruiting 11 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
57
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Multicenter, phase II trial with safety run-in to evaluate the efficacy and safety of momelotinib in patients with VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory and Somatic) syndrome with or without associated myelodysplastic syndrome (MDS).

The study will consist of two consecutive steps, a dose-finding safety run-in and a single-arm prospective phase II.

During safety run-in phase, three fixed dose levels will be tested according to a 3+3 design, using cohorts of size 3 in order to establish the maximum tolerated dose.

After this safety run-in phase, patients included in phase II will be treated with momelotinib at the maximum tolerated dose preliminary fixed.

Patients included in the phase II will receive momelotinib continuously until disease progression or loss of response, at physician's discretion.

All patients included in the study will receive glucocorticoids (prednisone/prednisolone equivalent) at baseline (at least > 10mg/day).

Response assessment regarding VEXAS related symptoms will be evaluated after 4, 12, 24 and 48 weeks. Response assessment regarding MDS features will be evaluated at 12 and 24 weeks.

Read the detailed description

During safety run-in phase, the three fixed dose levels tested are :

  • Dose level (DL) -1: 150 mg once daily (QD)
  • DL1: 200 mg QD
  • DL2: 300 mg QD. Between 6 and 18 patients will be enrolled during the safety run-in phase. Up to 39 patients could be included in the phase II study and will be treated with momelotinib at the maximum tolerated dose preliminary fixed during the safety run-in phase.

Baseline steroids daily dose required for VEXAS inflammatory manifestations will be defined during screening period (28 days period) for each patient. It is defined as the minimal daily dose of steroids used in the last 14 days prior momelotinib onset (according to physician disposition) that allow disease control. In case of related VEXAS inflammatory manifestation during screening period with a first fixed dose, an increased dose of steroids should be evaluated during at least an extra 14 days prior momelotinib onset. This baseline dose defined during screening period will be used for response criteria during follow-up.

Momelotinib treatment will be discontinued after 24 weeks at optimal dosing regimen (up to 300 mg/day), in case of absence of response.

Treatment might also be discontinued during follow-up in case of loss of response/hematological progression or non-tolerable adverse event.

02

Conditions studied

  • VEXAS Syndome
  • Myelo Dysplastic Syndrome

Keywords

  • VEXAS syndrome
  • Momelotinib
  • Myelodysplastic syndrome
03

In context

Myelodysplastic Syndromes

1,997 studies on the registry are indexed under Myelodysplastic Syndromes; 324 are open to participants now.

This study's planned enrollment of 57 is above the median of 40 across 1,611 interventional studies indexed under Myelodysplastic Syndromes.

Browse Myelodysplastic Syndromes studies →

Lead sponsor

Groupe Francophone des Myelodysplasies is the lead sponsor of 44 studies on the registry; 5 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.

Inclusion criteria

  • (Eastern Cooperative Oncology Group) performance status 0-2 at the time of screening
  • Age ≥ 18 years
  • Written
  • Diagnosis of VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory and Somatic) syndrome with UBA1 (Ubiquitin Like Modifier Activating Enzyme 1) mutation and clinically symptomatic disease requiring treatment and at least 10mg/d of
  • Patients with uncontrolled symptoms related to VEXAS with prior treatment line(s) (including steroids)
  • Patients /dependent to steroids
  • Single concomitant steroids therapy (e.g., prednisone or equivalent) at the time of inclusion is allowed
  • For patients treated with other immunosuppressive/immunomodulatory therapy than glucocorticoids, a wash out period of 28 days is required prior momelotinib onset
  • Erythropoietin/luspatercept used as a growth factor treatment is not allowed 28 days prior enrollment
  • Adequate liver function (serum transaminases ≤ 3 x (Upper Limits of Normal), ≤ 1.5 x ULN (isolated bilirubin > 1.5 x ULN is acceptable if bilirubin fractionated and direct bilirubin \< 35%)
  • Adequate renal function ( with (Modification of Diet in Renal Disease) formula > 30 ml/min)
  • Women of (i.e., women who are pre-menopausal or not surgically sterile) must:

    1. Have a negative serum or urine pregnancy test within 24 hours prior to beginning treatment on this study. Lactating patients are excluded.
    2. Agree to use, and to be able to comply with, effective without interruption, 4 weeks before starting study drug throughout the entire duration study drug therapy (including doses interruptions) and for 12 weeks after the end of the study drug therapy.
    3. Agree to learn about the procedures for preservation of egg before starting treatment.
  • Male patients must:

    1. Agree the need for the use of a condom if engaged in sexual activity with a woman of childbearing potential during the entire period of treatment, even if disruption of treatment and during 12 weeks after end of treatment.
    2. Agree to learn about the procedures for preservation of sperm before starting treatment.

Exclusion criteria

Exclusion Criteria:

  • Patients with MDS (Myelodysplastic syndrome) scheduled for stem cell transplant or high risk MDS according to IWG (International Working Group) 2023
  • Patients who are or have been already treated with Janus Kinase (JAK) inhibitors for VEXAS syndrome or another indication
  • Patients who are unable to receive a starting daily dose of momelotinib of at least 100 mg
  • Subjects with any other active are not eligible, except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer from which subject has been disease-free for at least 3 years
  • Uncontrolled congestive heart failure ( Classification 3 or 4), angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, , or pulmonary embolism within 12 weeks prior to initiation of momelotinib
  • Known infection with acute and chronic active , Virus, Virus
  • Any medical or psychiatric condition not allowing the of the subject
  • Presence of active bacterial, fungal, parasitic or viral infection which requires therapy
  • Previous history of Progressive Multifocal Leuko-encephalopathy
  • Active gastrointestinal conditions that may affect absorption
  • No affiliation to a health insurance system
  • Known to the study medicinal product, the metabolites, or formulation
Terms in these criteria, in plain language(22)

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.

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.

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.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

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.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

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.

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.

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.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

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.

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.

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.

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.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
57 participants (estimated)

Study arms

  • Experimental
    Momelotinib treatment

    Patients will receive momelotinib.

    Drug: Momelotinib treatment

Interventions

  • DrugMomelotinib treatment

    Patients included will receive momelotinib continuously until disease progression or loss of response, at physician's discretion.

06

What researchers measure

Primary outcomes

  1. Determination of the maximum tolerated dose of momelotinib

    The maximum tolerated dose (MTD) is defined by a target dose-limiting toxicities (DLT) rate of 30%, assessed during the observation window by a 3+3 design. The 3+3 design will enroll a first cohort of 3 patients at the starting dose of 200 mg/d: * If 0 of the 3 patients at the dose of 200 mg/d experienced a DLT during the first 4-week cycle of momelotinib, the dose will escalate to 300 mg/d for the next cohort. * If 1 of the 3 patients at the dose of 200 mg/d has a DLT, a cohort of three additional patients will be treated at the same dose of 200 mg/d. * If \> 1 patient of the 3 patients at the dose of 200 mg/d have a DLT, the dose will de-escalate to 150 mg/d for the next cohort. The same process will be repeated until reaching the MTD. In total, between 6 and 18 patients will be enrolled during this safety run-in phase.

    Time frame: First 4-week cycle of momelotinib treatment

  2. Clinical efficacy

    Determination of overall clinical response rate at 24 weeks after momelotinib initiation on VEXAS related symptoms (including complete (CR) or partial response (PR)) : * CR includes complete disappearance of symptoms related to systemic inflammation according to treating physician and daily dose of steroids ≤ 10 mg/d (equivalent prednisolone). * PR includes complete disappearance of symptoms related to systemic inflammation according to treating physician and reduction of at least 50% of daily dose steroids compared to baseline and/or daily dose of steroids \> 10 mg/d.

    Time frame: During the 24 first weeks of momelotinib treatment

Secondary outcomes

  1. Pharmacokinetic

    Concentrations of momelotinib and its major metabolite M21 will be determined in plasma samples using the currently approved bioanalytical methodology by Frontage Laboratories Inc. Pharmacokinetic sampling will be only performed for patients in safety run-in phase. Samples should be obtained at cycle 1 Day 8 and cycle 13 Day 8, at times following : Pre-dose then at 0.5 h, 1 h, 1.5 h, 2 h, 3 h, 4 h, 6 h, 8h and at 24 h post Day 8 dose.

    Time frame: At cycle 1 Day 8-9 and cycle 13 Day 8-9

  2. Incidence of Treatment-Emergent Adverse Events

    Collection of Adverse events (AE), serious AE (SAE) and toxicities as measured by NCI CTCAE (National Cancer Institute Common Terminology Criteria for Adverse Events) v5.0

    Time frame: From enrollment to the end of treatment at 48 weeks

  3. Response

    Determination of overall clinical response rates (including Complete Response or Partial Response) and biological response rates (complete or partial)

    Time frame: After 4, 12, 24 and 48 weeks of momelotinib treatment

  4. Hematological response

    Erythroid hematological improvement will be assessed by the investigators according to IWG 2018 criteria through collection of transfusion records and hematology parameters.

    Time frame: After 16 weeks of momelotinib treatment

  5. Steroids dose reduction

    Steroids dose reduction compared to baseline and/or steroids withdrawal rates

    Time frame: After 24 weeks of momelotinib treatment

  6. Overall survival

    Overall survival assessment

    Time frame: From enrollment to the end of treatment at 12 months

  7. Myelodysplastic syndrome (MDS) evolution

    Changes in the underlying MDS from baseline, at 12 and 24 weeks, including MDS progression based on hematological, cytogenetic and molecular analysis

    Time frame: From baseline at 12 and 24 weeks of momelotinib treatment

  8. Duration of response

    Duration of response on VEXAS symptoms defined as the time from the date of initial documentation of a clinical response (Complete Response or Partial Response) to the date of first documented evidence of relapse or death

    Time frame: From enrollment to the end of treatment at 48 weeks

  9. Best clinical response

    Determination of time to the first and best clinical response

    Time frame: From enrollment to the end of treatment at 48 weeks

  10. RBC independency

    Duration of Red Blood Count (RBC) independency in patients with RBC dependency at time of inclusion, according to IWG 2018 criteria

    Time frame: From enrollment to the end of treatment at 48 weeks

  11. UBA1 VAF

    Evolution of UBA1 (Ubiquitin Like Modifier Activating Enzyme 1) VAF (Variant Allelic Frequency) from baseline to W4, W12 and W24 after momelotinib treatment

    Time frame: From enrollment to the end of treatment at 24 weeks

Other outcomes

  1. Validation of the VEXAS personal scoring system (VPSS)

    Measurement of VPSS to validate the score currently under development which would allow objectively quantifying the impact of VEXAS-related symptoms on patients' quality of life.

    Time frame: After 4, 12 and 24 weeks of momelotinib treatment

07

Study locations

2 of 11 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Nov 2025 (actual). Primary completion is estimated for Jun 2028, 31 months after the start.

Of 227 non-industry phase 2 interventional studies under Myelodysplastic Syndromes, half reached primary completion within 76 months of starting (the median), counting those still running; a quarter within 44 and three quarters within 116. This study's planned 31 months is below that.

Counting every sponsor, half of 279 studies reached it within 66 months; a quarter within 40 and three quarters within 104.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 18, 2025
First posted
Aug 1, 2025
StartActual
Nov 25, 2025
Primary completionEst.
Jun 2028
CompletionEst.
Nov 2028
Last update
Aug 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07098936
Lead sponsor
Groupe Francophone des Myelodysplasies
Collaborators
GlaxoSmithKline
Responsible party
Sponsor
First posted
Aug 1, 2025
Start date
Nov 25, 2025
Primary completion
Jun 2028 (estimated)
Completion
Nov 2028 (estimated)
Last update
Aug 10, 2026

Study contacts

Maël HEIBLIG, MD
Contact
mael.heiblig@chu-lyon.fr
+33 4 72 11 74 01
Maël HEIBLIG, MD
principal investigator · CH Lyon Sud

Oversight

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

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