Table 1.

Overview of recent FDA-approved agents for GVHD

Agent	Mechanism of action	FDA-approved indication	Recommended starting dosage	Key toxicity considerations
Ruxolitinib	Selective inhibition of Janus kinases 1 and 2	Adult or pediatric patients 12 years and older with steroid-refractory acute GVHD	5 mg orally twice daily	Thrombocytopenia Anemia Neutropenia CMV infection Peripheral edema Sepsis Pulmonary Hemorrhage
		Adult or pediatric patients 12 years and older with chronic GVHD after failure of one or two lines of systemic therapy	10 mg orally twice daily
Ibrutinib	Selective inhibition of Bruton’s tyrosine kinase	Adult patients with chronic GVHD after failure of one or more lines of systemic therapy	420 mg orally once daily	Fatigue Diarrhea Muscle spasms Pneumonia Atrial arrhythmias Fungal infections
Belumosudil	Selective inhibition of rho-associated coiled-coil-containing protein kinase-2	Adult or pediatric patients 12 years and older with chronic GVHD after failure of at least 2 prior lines of systemic therapy	200 mg orally once daily	Fatigue Diarrhea Nausea URI Pneumonia Hypertension Hyperglycemia Elevated Liver Function Tests

Abbreviations: CMV, cytomegalovirus; FDA, US Food and Drug Administration; GVHD, graft-versus-host disease; mg, milligram; URI, upper respiratory tract infection.