| Leukemia, Myelocytic, Acute
Trisenox vs Tibsovo
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Trisenox vs Tibsovo 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 signalsTibsovo has a higher rate of injection site reactions vs Trisenox based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tibsovo but not Trisenox, including UnitedHealthcare
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Category
Trisenox
Tibsovo
At A Glance
Intravenous
Daily
Arsenical antineoplastic
Oral
Daily
IDH1 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
- MYELODYSPLASTIC SYNDROME
- Cholangiocarcinoma
Dosing
Acute Promyelocytic Leukemia (newly-diagnosed low-risk) Induction: 0.15 mg/kg/day IV daily in combination with tretinoin until bone marrow remission, not to exceed 60 days. Consolidation: 0.15 mg/kg/day IV daily for 5 days per week during weeks 1-4 of each 8-week cycle for 4 cycles in combination with tretinoin.
Acute Promyelocytic Leukemia (relapsed or refractory) Induction: 0.15 mg/kg/day IV daily until bone marrow remission, not to exceed 60 days. Consolidation: 0.15 mg/kg/day IV daily for 25 doses over a period of up to 5 weeks, beginning 3 to 6 weeks after completion of induction.
Leukemia, Myelocytic, Acute 500 mg orally once daily; newly diagnosed: in combination with azacitidine 75 mg/m2 SC or IV on Days 1-7 of each 28-day cycle, or as monotherapy, for minimum 6 months; relapsed/refractory: monotherapy until disease progression or unacceptable toxicity.
MYELODYSPLASTIC SYNDROME 500 mg orally once daily as monotherapy until disease progression or unacceptable toxicity; continue for minimum 6 months.
Cholangiocarcinoma 500 mg orally once daily until disease progression or unacceptable toxicity.
Contraindications
- Hypersensitivity to arsenic
—
Adverse Reactions
Most common (>=30%) Nausea, cough, fatigue, pyrexia, headache, abdominal pain, vomiting, tachycardia, diarrhea, dyspnea, hypokalemia, leukocytosis, hyperglycemia, hypomagnesemia, insomnia, dermatitis, edema, QTc prolongation, rigors, sore throat, arthralgia, paresthesia, pruritus
Serious Differentiation syndrome, cardiac conduction abnormalities, QTc prolongation, encephalopathy, hepatotoxicity, hyperleukocytosis, atrial dysrhythmias, hyperglycemia
Postmarketing Ventricular tachycardia, torsade de pointes, atrioventricular block, congestive heart failure, deafness, pancytopenia, bone marrow necrosis, peripheral neuropathy, seizures, confusion, encephalopathy, Wernicke's encephalopathy, posterior reversible encephalopathy syndrome, toxic epidermal necrolysis, rhabdomyolysis, melanoma, pancreatic cancer, squamous cell carcinoma
Most common (>=25%) leukocytes decreased, diarrhea, hemoglobin decreased, platelets decreased, glucose increased, fatigue, alkaline phosphatase increased, edema, potassium decreased, nausea, vomiting, phosphatase decreased, decreased appetite, sodium decreased, leukocytosis, magnesium decreased, aspartate aminotransferase increased, arthralgia, dyspnea, uric acid increased, abdominal pain, creatinine increased, mucositis, rash, electrocardiogram QT prolonged, differentiation syndrome, calcium decreased, neutrophils decreased, myalgia
Serious differentiation syndrome, electrocardiogram QT prolonged, leukocytosis, Guillain-Barre syndrome
Pharmacology
The mechanism of action is not completely understood. Arsenic trioxide causes morphological changes and DNA fragmentation characteristic of apoptosis in promyelocytic leukemia cells and causes damage or degradation of the PML-RAR-alpha fusion protein.
Ivosidenib is a small molecule inhibitor of the mutant isocitrate dehydrogenase 1 (IDH1) enzyme that reduces 2-hydroxyglutarate (2-HG) levels and induces myeloid differentiation in IDH1-mutated AML; in IDH1-mutated cholangiocarcinoma, it also reduces 2-HG levels in tumor tissue.
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Most Common Insurance
Anthem BCBS
Trisenox
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Tibsovo
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (4/12) · Qty limit (12/12)
UnitedHealthcare
Trisenox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Tibsovo
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Trisenox
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Tibsovo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Acute Myeloid Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Tibsovo.
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TrisenoxView full Trisenox profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.