| Acute lymphocytic leukemia

Rylaze vs Besponsa

Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.

Deep comparison between: Rylaze vs Besponsa with Prescriber.AI

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Safety signalsBesponsa has a higher rate of injection site reactions vs Rylaze based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Besponsa but not Rylaze, including UnitedHealthcare

Category

Rylaze

Besponsa

At A Glance

RouteIM injection

FrequencyEvery 48 hours

ClassRecombinant L-asparaginase

RouteIV infusion

FrequencyDays 1, 8, and 15 per cycle

ClassCD22-directed antibody-drug conjugate

Indications

Acute lymphocytic leukemia
Precursor cell lymphoblastic lymphoma

Acute lymphocytic leukemia

Dosing

Acute lymphocytic leukemia, Precursor cell lymphoblastic lymphoma 25 mg/m2 IM every 48 hours, or 25 mg/m2 IM on Monday and Wednesday mornings and 50 mg/m2 IM on Friday afternoon, as replacement for a long-acting asparaginase product; premedicate with acetaminophen, H-1 blocker, and H-2 blocker 30-60 minutes prior to administration.

Acute lymphocytic leukemia Cycle 1: 1.8 mg/m2/cycle as 0.8 mg/m2 on Day 1 and 0.5 mg/m2 on Days 8 and 15 (21-day cycle, extendable to 28 days); subsequent cycles (CR/CRi): 1.5 mg/m2/cycle as 0.5 mg/m2 on Days 1, 8, and 15 (28-day cycle); subsequent cycles (non-CR/CRi): 1.8 mg/m2/cycle as 0.8 mg/m2 on Day 1 and 0.5 mg/m2 on Days 8 and 15 (28-day cycle); administered by IV infusion over 1 hour with premedication (corticosteroid, antipyretic, antihistamine).

Contraindications

History of serious hypersensitivity reactions to Erwinia asparaginase, including anaphylaxis
History of serious pancreatitis during previous asparaginase therapy
History of serious thrombosis during previous asparaginase therapy
History of serious hemorrhagic events during previous asparaginase therapy
Severe hepatic impairment

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Drug Interactions

848View drug interactions

1075View drug interactions

Adverse Reactions

Most common (>20%) Abnormal liver test, nausea, musculoskeletal pain, infection, fatigue, headache, febrile neutropenia, pyrexia, hemorrhage, stomatitis, abdominal pain, decreased appetite, drug hypersensitivity, hyperglycemia, diarrhea, pancreatitis, hypokalemia

Serious Febrile neutropenia, infection, drug hypersensitivity, pyrexia, nausea, dehydration, stomatitis, acute kidney injury, pancreatitis, diarrhea, viral infection

Postmarketing Veno-occlusive disease (VOD)

Most common (>=20%) Thrombocytopenia, neutropenia, infection, anemia, leukopenia, fatigue, hemorrhage, pyrexia, nausea, headache, febrile neutropenia, transaminases increased, abdominal pain, gamma-glutamyltransferase increased, hyperbilirubinemia

Serious Infection, febrile neutropenia, hemorrhage, abdominal pain, pyrexia, veno-occlusive disease (VOD), fatigue

Pharmacology

Asparaginase erwinia chrysanthemi (recombinant)-rywn is a recombinant bacterial enzyme that catalyzes the conversion of L-asparagine to aspartic acid and ammonia, depleting plasma asparagine and killing leukemic cells that depend on exogenous asparagine for survival due to low asparagine synthetase expression.

CD22-directed antibody-drug conjugate (ADC); inotuzumab binds CD22-expressing tumor cells, enabling internalization and intracellular release of N-acetyl-gamma-calicheamicin dimethylhydrazide, which induces double-strand DNA breaks leading to cell cycle arrest and apoptotic cell death.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Rylaze