| Leukemia, Myelocytic, Acute

Nivestym vs Rydapt

Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.

Deep comparison between: Nivestym vs Rydapt with Prescriber.AI

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Safety signalsRydapt has a higher rate of injection site reactions vs Nivestym based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Rydapt but not Nivestym, including UnitedHealthcare

Category

Nivestym

Rydapt

At A Glance

RouteSC injection or IV infusion

FrequencyDaily

ClassG-CSF analog

RouteOral

FrequencyTwice daily

ClassMulti-kinase inhibitor

Indications

Leukemia, Myelocytic, Acute
Severe congenital neutropenia
Cyclic neutropenia
Idiopathic neutropenia

Leukemia, Myelocytic, Acute
Aggressive Systemic Mastocytosis
Systemic mastocytosis with associated clonal, hematologic non-mast-cell lineage disease
Leukemia, Mast-Cell

Dosing

Cancer receiving myelosuppressive chemotherapy, Leukemia, Myelocytic, Acute 5 mcg/kg/day SC injection, short IV infusion (15-30 min), or continuous IV infusion; administer at least 24 hours after cytotoxic chemotherapy; continue daily for up to 2 weeks or until ANC reaches 10,000/mm3 after the expected nadir.

Cancer undergoing bone marrow transplantation 10 mcg/kg/day IV infusion no longer than 24 hours; administer first dose at least 24 hours after cytotoxic chemotherapy and at least 24 hours after bone marrow infusion; titrate against neutrophil response per dosage adjustment table.

Autologous peripheral blood progenitor cell mobilization 10 mcg/kg/day SC injection; administer at least 4 days before first leukapheresis and continue until last leukapheresis; discontinue if WBC rises above 100,000/mm3.

Severe congenital neutropenia 6 mcg/kg SC injection twice daily; individualize based on clinical course and ANC with chronic daily administration.

Cyclic neutropenia, Idiopathic neutropenia 5 mcg/kg SC injection once daily; individualize based on clinical course and ANC with chronic daily administration.

Leukemia, Myelocytic, Acute 50 mg orally twice daily with food on Days 8 to 21 of each induction cycle with cytarabine and daunorubicin and on Days 8 to 21 of each consolidation cycle with high-dose cytarabine.

Aggressive Systemic Mastocytosis, Systemic mastocytosis with associated clonal, hematologic non-mast-cell lineage disease, Leukemia, Mast-Cell 100 mg orally twice daily with food; continue until disease progression or unacceptable toxicity.

Contraindications

History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim products or pegfilgrastim products

Hypersensitivity to midostaurin or any excipient, including reactions such as anaphylactic shock, dyspnea, flushing, chest pain, and angioedema

Drug Interactions

823View drug interactions

1145View drug interactions

Adverse Reactions

Most common (>=5% higher incidence vs placebo) Pyrexia, nausea, fatigue, thrombocytopenia, back pain, bone pain, rash, dizziness, dyspnea, cough, chest pain, arthralgia, pain in extremity, increased blood alkaline phosphatase, increased blood lactate dehydrogenase

Serious Splenic rupture, acute respiratory distress syndrome, serious allergic reactions, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, myelodysplastic syndrome, acute myeloid leukemia, thrombocytopenia, leukocytosis, cutaneous vasculitis, aortitis

Postmarketing Anaphylaxis, splenomegaly, Sweet's syndrome, decreased bone density and osteoporosis (pediatric chronic use), extramedullary hematopoiesis

Most common (>=20%) - AML Febrile neutropenia, nausea, mucositis, vomiting, headache, petechiae, musculoskeletal pain, epistaxis, device-related infection, hyperglycemia, ECG QT prolonged, upper respiratory tract infections

Most common (>=20%) - Systemic Mastocytosis Nausea, vomiting, diarrhea, edema, musculoskeletal pain, abdominal pain, fatigue, upper respiratory tract infection, constipation, pyrexia, headache, dyspnea

Serious Pulmonary toxicity, febrile neutropenia, sepsis, gastrointestinal hemorrhage, pneumonia, cardiac events

Postmarketing Interstitial lung disease, acute febrile neutrophilic dermatosis (Sweet syndrome)

Pharmacology

Filgrastim-aafi is a recombinant G-CSF analog that binds to specific cell surface receptors on hematopoietic cells, stimulating neutrophil progenitor proliferation, differentiation, and end-cell functional activation; its activity is selective for the neutrophil lineage with minimal effects on other hematopoietic cell types.

Midostaurin is a multi-kinase inhibitor that inhibits wild type and mutant FLT3, KIT (wild type and D816V), PDGFRalpha/beta, and members of the PKC serine/threonine kinase family, inducing apoptosis in leukemic cells expressing FLT3 mutations and inhibiting KIT signaling and histamine release in mast cells.

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Most Common Insurance

Anthem BCBS

Nivestym