# Luspatercept

Source: https://onco.cc/drugs/luspatercept/  
OnCo record `luspatercept` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An injection that helps the marrow finish making red cells, reducing or removing the need for transfusions in lower-risk MDS and beta-thalassaemia.

## Summary

MEDALIST (2020) established transfusion independence in ring-sideroblast MDS after ESA failure; COMMANDS (2023) showed superiority to epoetin alfa in ESA-naive lower-risk MDS, making it a first-line option. Also approved in beta-thalassaemia (BELIEVE) and studied in myelofibrosis anaemia (INDEPENDENCE).

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill
- Brand: Reblozyl
- Modality: Erythroid maturation agent (activin receptor IIB ligand trap, Fc fusion)
- Mechanism: Binds TGF-β superfamily ligands (GDF11, activin B) to relieve SMAD2/3 suppression of late-stage erythropoiesis.
- Approvals: US 2019: Beta-thalassaemia transfusion-dependent anaemia; US 2020: Very low- to intermediate-risk MDS with ring sideroblasts after ESA failure; US 2023: First-line anaemia in ESA-naive lower-risk MDS; EU 2020: MDS-RS and beta-thalassaemia

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Luspatercept
- COMMANDS (Lancet 2023): https://doi.org/10.1016/S0140-6736(23)00874-7
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=luspatercept

## Connected records

- cancers: [Chronic myelomonocytic leukaemia and MDS/MPN overlap neoplasms](https://onco.cc/cancers/cmml/), [Lower-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-lower-risk/), [Myelodysplastic syndromes / neoplasms (MDS)](https://onco.cc/cancers/mds/), [Myeloproliferative neoplasms (PV, ET, myelofibrosis)](https://onco.cc/cancers/myeloproliferative-neoplasms/), [Primary myelofibrosis](https://onco.cc/cancers/primary-myelofibrosis/)
- technologies: [Transfusion support and anaemia management](https://onco.cc/technologies/transfusion-support/)
- companies: [Bristol Myers Squibb](https://onco.cc/companies/bms/)
- trials: [A Study to Evaluate Long-term Safety in Participants Who Have Participated in Other Luspatercept (ACE-536) Clinical Trials](https://onco.cc/trials/nct04064060/), [An Efficacy and Safety Study of Luspatercept (ACE-536) Versus Placebo in Subjects With Myeloproliferative Neoplasm-Associated Myelofibrosis on Concomi](https://onco.cc/trials/nct04717414/), [COMMANDS](https://onco.cc/trials/commands/), [MEDALIST](https://onco.cc/trials/medalist/)
- key papers: [COMMANDS: luspatercept versus epoetin alfa as first treatment for anaemia in lower-risk MDS needing transfusions](https://onco.cc/key-papers/paper-commands-luspatercept-mds-lancet-2023/), [IMerge: imetelstat, a telomerase inhibitor, for transfusion-dependent lower-risk MDS after erythropoietin has failed](https://onco.cc/key-papers/paper-imerge-imetelstat-mds-lancet-2024/)
- terms: [Anaemia](https://onco.cc/terms/anaemia/), [del(5q) (5q- syndrome and lenalidomide response)](https://onco.cc/terms/del5q/), [IPSS-R and IPSS-M (myelodysplastic syndrome risk scores)](https://onco.cc/terms/ipss-m-ipss-r/), [SF3B1 mutation](https://onco.cc/terms/sf3b1-mutation/)
- targets: [SMAD2](https://onco.cc/targets/smad2/)

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