| Acute lymphocytic leukemia
Xatmep vs Oncaspar
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Xatmep vs Oncaspar 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 signalsOncaspar has a higher rate of injection site reactions vs Xatmep based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Oncaspar but not Xatmep, including UnitedHealthcare
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Category
Xatmep
Oncaspar
At A Glance
Oral
Once weekly
Folate analog metabolic inhibitor
IM injection or IV infusion
Every 14 days
PEGylated L-asparaginase
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 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.
Contraindications
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
- 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
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 (>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
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.
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.
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)
Oncaspar
- 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)
Oncaspar
- Covered on 4 commercial plans
- PA (0/8) · 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)
Oncaspar
- Covered on 0 commercial plans
- PA (3/3) · 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.