| Acute lymphocytic leukemia
Oncaspar vs Xatmep
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Oncaspar vs Xatmep with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXatmep has a higher rate of injection site reactions vs Oncaspar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xatmep but not Oncaspar, including UnitedHealthcare
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Category
Oncaspar
Xatmep
At A Glance
IM injection or IV infusion
Every 14 days
PEGylated L-asparaginase
Oral
Once weekly
Folate analog metabolic inhibitor
Indications
- Acute lymphocytic leukemia
- Acute lymphocytic leukemia
- Juvenile polyarthritis
Dosing
Acute lymphocytic leukemia 2,500 IU/m2 (age <=21 years) or 2,000 IU/m2 (age >21 years) IM or IV, no more frequently than every 14 days.
Acute lymphocytic leukemia 20 mg/m2 given one time weekly as part of a multi-agent combination chemotherapy maintenance regimen, oral.
Juvenile polyarthritis Starting dose of 10 mg/m2 given one time weekly, oral; titrate gradually to achieve optimal response, up to 30 mg/m2/week in pediatric patients.
Contraindications
- History of serious hypersensitivity reactions, including anaphylaxis, to ONCASPAR or any excipient
- History of serious thrombosis with prior L-asparaginase therapy
- History of pancreatitis, including pancreatitis related to prior L-asparaginase therapy
- History of serious hemorrhagic events with prior L-asparaginase therapy
- Severe hepatic impairment
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
Adverse Reactions
Most common (>5%) Elevated transaminase, febrile neutropenia, hypertriglyceridemia, hypoalbuminemia, bilirubin increased, hyperglycemia, pancreatitis, abnormal clotting studies, embolic and thrombotic events, hypersensitivity, sepsis, infections
Serious Anaphylaxis and serious hypersensitivity reactions, thrombosis, pancreatitis, glucose intolerance, hemorrhage, hepatotoxicity including veno-occlusive disease
Postmarketing Coagulopathy, hepatic impairment, pancreatic cyst, veno-occlusive disease, anaphylactic shock, blood cholesterol increased, hyperglycemia, hyperammonemia, osteonecrosis, hemorrhage including CNS hemorrhage, thrombosis including superior sagittal sinus thrombosis
Most common Ulcerative stomatitis, leukopenia, nausea, abdominal distress, malaise, fatigue, chills, fever, dizziness, decreased resistance to infection
Serious Bone marrow suppression, serious infections, renal toxicity, gastrointestinal toxicity, hepatic toxicity, pulmonary toxicity, hypersensitivity and dermatologic reactions, secondary malignancies, infertility
Postmarketing Pancytopenia, aplastic anemia, thromboembolic events, hepatotoxicity, cirrhosis, fatal opportunistic infections (including Pneumocystis jiroveci pneumonia), leukoencephalopathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, pulmonary fibrosis
Pharmacology
ONCASPAR is a PEGylated L-asparaginase that catalyzes the conversion of L-asparagine to aspartic acid and ammonia, depleting plasma asparagine and killing leukemic cells that have low asparagine synthetase expression and depend on an exogenous asparagine source for survival.
Methotrexate inhibits dihydrofolic acid reductase, interfering with DNA synthesis, repair, and cellular replication by blocking reduction of dihydrofolates to tetrahydrofolates required for purine nucleotide and thymidylate synthesis; the mechanism in pJIA is unknown but may affect immune function.
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Most Common Insurance
Anthem BCBS
Oncaspar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Xatmep
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (2/12) · Qty limit (0/12)
UnitedHealthcare
Oncaspar
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xatmep
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Oncaspar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Xatmep
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Acute Lymphoblastic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Xatmep.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.