| Acute lymphocytic leukemia
Xatmep vs Rituxan
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Xatmep vs Rituxan 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 signalsRituxan has a higher rate of injection site reactions vs Xatmep based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rituxan but not Xatmep, including UnitedHealthcare
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Category
Xatmep
Rituxan
At A Glance
Oral
Once weekly
Folate analog metabolic inhibitor
IV infusion
Anti-CD20 monoclonal antibody
Indications
- Acute lymphocytic leukemia
- Juvenile polyarthritis
- Lymphoma, Non-Hodgkin
- Chronic Lymphocytic Leukemia
- Rheumatoid Arthritis
- Granulomatosis with polyangiitis
- Microscopic Polyarteritis
- Pemphigus Vulgaris
- 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.
Lymphoma, Non-Hodgkin 375 mg/m2 IV; weekly for 4 or 8 doses for relapsed/refractory low-grade or follicular NHL; Day 1 of each chemotherapy cycle for up to 8 doses for previously untreated follicular or DLBCL; every 8 weeks for 12 doses as single-agent maintenance.
Acute lymphocytic leukemia 375 mg/m2 IV for 6 total infusions in combination with LMB chemotherapy (two doses during each of the two induction courses, one dose during each of the two consolidation courses) for pediatric patients aged 6 months and older.
Chronic Lymphocytic Leukemia 375 mg/m2 IV the day prior to initiation of cycle 1 FC chemotherapy, then 500 mg/m2 on Day 1 of cycles 2-6 every 28 days.
Rheumatoid Arthritis Two 1,000 mg IV infusions separated by 2 weeks per course in combination with methotrexate; subsequent courses every 24 weeks (no sooner than 16 weeks); premedicate with methylprednisolone 100 mg IV 30 minutes prior to each infusion.
Granulomatosis with polyangiitis, Microscopic Polyarteritis Induction: 375 mg/m2 IV once weekly for 4 weeks with glucocorticoids; follow-up: two 500 mg IV infusions separated by 2 weeks, then 500 mg IV every 6 months based on clinical evaluation.
Pemphigus Vulgaris Two 1,000 mg IV infusions separated by 2 weeks in combination with a tapering course of glucocorticoids; then 500 mg IV at Month 12 and every 6 months thereafter or based on clinical evaluation.
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 (>=25%) Infusion-related reactions, fever, lymphopenia, chills, infection, asthenia (in NHL); infusion-related reactions, neutropenia (in CLL)
Serious Fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B reactivation with fulminant hepatitis, progressive multifocal leukoencephalopathy, tumor lysis syndrome, sepsis, cardiovascular events, renal toxicity, bowel obstruction and perforation
Postmarketing Prolonged pancytopenia, fatal cardiac failure, progressive multifocal leukoencephalopathy, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease, posterior reversible encephalopathy syndrome
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.
Rituximab is a chimeric murine/human IgG1 kappa monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).
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Most Common Insurance
Anthem BCBS
Xatmep
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (2/12) · Qty limit (0/12)
Rituxan
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Xatmep
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Rituxan
- 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)
Rituxan
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Xatmep.
No savings programs available for Rituxan.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.