| Hematopoietic subsyndrome of acute radiation syndrome
Nplate vs Leukine
Side-by-side clinical, coverage, and cost comparison for hematopoietic subsyndrome of acute radiation syndrome.Deep comparison between: Nplate vs Leukine 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 signalsLeukine has a higher rate of injection site reactions vs Nplate based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Leukine but not Nplate, including UnitedHealthcare
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Category
Nplate
Leukine
At A Glance
SC injection
Once weekly (ITP); single dose (HS-ARS)
Thrombopoietin receptor agonist
IV infusion or SC injection
Once daily
GM-CSF
Indications
- Immune thrombocytopenic purpura
- Hematopoietic subsyndrome of acute radiation syndrome
- Leukemia, Myelocytic, Acute
- Lymphoma, Non-Hodgkin
- Acute lymphocytic leukemia
- Hodgkin Disease
- Hematopoietic subsyndrome of acute radiation syndrome
Dosing
Immune thrombocytopenic purpura Initial dose 1 mcg/kg SC injection once weekly; adjust by 1 mcg/kg increments based on platelet count; maximum weekly dose 10 mcg/kg.
Hematopoietic subsyndrome of acute radiation syndrome 10 mcg/kg as a single SC injection, administered as soon as possible after suspected or confirmed exposure to myelosuppressive doses of radiation (>2 Gy).
Leukemia, Myelocytic, Acute 250 mcg/m2/day IV over a 4-hour period starting day 11 or four days after induction chemotherapy completion; continue until ANC >1500 cells/mm3 for 3 consecutive days or up to 42 days.
Lymphoma, Non-Hodgkin, Acute lymphocytic leukemia, Hodgkin Disease 250 mcg/m2/day IV over 24 hours or SC once daily beginning immediately following progenitor cell infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Autologous or allogeneic bone marrow transplantation 250 mcg/m2/day IV over a 2-hour period beginning 2-4 hours after bone marrow infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Delayed neutrophil recovery or graft failure 250 mcg/m2/day for 14 days as a 2-hour IV infusion; may repeat after 7 days off therapy if neutrophil recovery has not occurred, up to three courses.
Hematopoietic subsyndrome of acute radiation syndrome SC injection once daily: 7 mcg/kg for adults and pediatric patients >40 kg, 10 mcg/kg for pediatric patients 15-40 kg, 12 mcg/kg for pediatric patients <15 kg; continue until ANC >1000/mm3 for three consecutive CBCs.
Contraindications
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- History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product
Adverse Reactions
Most common (>=5%) Arthralgia, myalgia, pain in extremity, shoulder pain, dizziness, paresthesia, insomnia, abdominal pain, dyspepsia (adults); contusion, upper respiratory tract infection, oropharyngeal pain, pyrexia, rash, diarrhea (pediatric)
Serious Progression of myelodysplastic syndromes, thrombotic/thromboembolic complications, loss of response, bone marrow reticulin formation and collagen fibrosis
Postmarketing Erythromelalgia, hypersensitivity reactions including angioedema and anaphylaxis
Most common (>=10%) Fever, nausea, diarrhea, vomiting, rash, alopecia, stomatitis, asthenia, malaise, anorexia, edema, headache, chills, peripheral edema, dyspnea
Serious Hypersensitivity and anaphylaxis, infusion-related reactions, severe myelosuppression, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis
Postmarketing Infusion-related reactions, serious allergic reactions including anaphylaxis, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis including eosinophilia, thromboembolic events, injection site reactions
Pharmacology
Thrombopoietin receptor agonist; Fc-peptide fusion protein (peptibody) that binds and activates the TPO receptor to increase platelet production through a mechanism analogous to endogenous TPO.
Sargramostim (GM-CSF) is a colony-stimulating factor that supports survival, clonal expansion, and differentiation of hematopoietic progenitor cells, inducing partially committed progenitors to divide and differentiate into granulocyte-macrophage pathways including neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells; it can also activate mature granulocytes and macrophages and promote proliferation of megakaryocytic and erythroid progenitors.
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Most Common Insurance
Anthem BCBS
Nplate
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Leukine
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (6/12) · Qty limit (0/12)
UnitedHealthcare
Nplate
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Leukine
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nplate
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Leukine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAmgen Safety Net Foundation
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Chemotherapy Induced Neutropenia
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.