| Leukemia, Myelocytic, Acute
Trisenox vs Vanflyta
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Trisenox vs Vanflyta 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 signalsVanflyta has a higher rate of injection site reactions vs Trisenox based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vanflyta but not Trisenox, including UnitedHealthcare
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Category
Trisenox
Vanflyta
At A Glance
Intravenous
Daily
Arsenical antineoplastic
Oral
Once daily
FLT3 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
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 Induction: 35.4 mg orally once daily on Days 8 to 21 of each 28-day cycle, up to 2 cycles with cytarabine and anthracycline; Consolidation: 35.4 mg once daily on Days 6 to 19 of each cycle, up to 4 cycles with high-dose cytarabine; Maintenance: 26.5 mg once daily (escalate to 53 mg on Day 15 if QTcF <=450 ms), continuous once-daily with no break for up to 36 cycles.
Contraindications
- Hypersensitivity to arsenic
- Severe hypokalemia
- Severe hypomagnesemia
- Long QT syndrome
- History of ventricular arrhythmias or torsades de pointes
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 (>=10%) Febrile neutropenia, diarrhea, mucositis, nausea, sepsis, abdominal pain, vomiting, neutropenia, headache, upper respiratory tract infection, hypertransaminasemia, thrombocytopenia, fungal infection, herpesvirus infection, decreased appetite, epistaxis, insomnia, electrocardiogram QT prolonged, anemia, dyspepsia, eye irritation.
Serious Febrile neutropenia, sepsis, fungal infections, brain edema, pneumonia, cerebral infarction, acute respiratory distress syndrome, pulmonary embolism, ventricular dysfunction, cardiac arrest.
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.
Quizartinib is a small molecule inhibitor of the receptor tyrosine kinase FLT3; it and its active metabolite AC886 bind the ATP binding domain of FLT3, inhibiting kinase activity and downstream FLT3 receptor signaling, thereby blocking FLT3-ITD-dependent cell proliferation.
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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)
Vanflyta
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Trisenox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Vanflyta
- 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)
Vanflyta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Acute Myeloid Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Acute Myeloid 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.