| Acute lymphocytic leukemia
Rylaze vs Xatmep
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Rylaze 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 Rylaze based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xatmep but not Rylaze, including UnitedHealthcare
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Category
Rylaze
Xatmep
At A Glance
IM injection
Every 48 hours
Recombinant L-asparaginase
Oral
Once weekly
Folate analog metabolic inhibitor
Indications
- Acute lymphocytic leukemia
- Precursor cell lymphoblastic lymphoma
- Acute lymphocytic leukemia
- Juvenile polyarthritis
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 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 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
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
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 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
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.
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
Rylaze
- Covered on 5 commercial plans
- PA (11/12) · 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
Rylaze
- 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
Rylaze
- 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
$10/fillfill
JazzCares Copay Program: RylazeCommercial 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.