| Acute lymphocytic leukemia
Xatmep vs Besponsa
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Xatmep vs Besponsa 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 signalsBesponsa has a higher rate of injection site reactions vs Xatmep based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Besponsa but not Xatmep, including UnitedHealthcare
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Category
Xatmep
Besponsa
At A Glance
Oral
Once weekly
Folate analog metabolic inhibitor
IV infusion
Days 1, 8, and 15 per cycle
CD22-directed antibody-drug conjugate
Indications
- Acute lymphocytic leukemia
- Juvenile polyarthritis
- Acute lymphocytic leukemia
Dosing
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.
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
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
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Adverse Reactions
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
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
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.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Xatmep
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (2/12) · Qty limit (0/12)
Besponsa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Xatmep
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Besponsa
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Xatmep
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Besponsa
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Xatmep.
Cost estimate not availableCancerCare: Acute Lymphoblastic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.