| Leukemia, Myelocytic, Acute
Trisenox vs Venclexta
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Trisenox vs Venclexta 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 signalsVenclexta has a higher rate of injection site reactions vs Trisenox based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Venclexta but not Trisenox, including UnitedHealthcare
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Category
Trisenox
Venclexta
At A Glance
Intravenous
Daily
Arsenical antineoplastic
Oral
Once daily
BCL-2 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Chronic Lymphocytic Leukemia
- Small Lymphocytic Lymphoma
- 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.
Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma 5-week ramp-up starting at 20 mg, increasing to 400 mg orally once daily; used as monotherapy or in combination with acalabrutinib, obinutuzumab, or rituximab.
Leukemia, Myelocytic, Acute 3- or 4-day ramp-up to 400 mg orally once daily in combination with azacitidine or decitabine, or 600 mg orally once daily in combination with low-dose cytarabine, each in 28-day cycles.
Contraindications
- Hypersensitivity to arsenic
- Concomitant use with strong CYP3A inhibitors at initiation and during the ramp-up phase in patients with Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma due to increased risk of tumor lysis syndrome
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 (>=20%) in CLL/SLL Neutropenia, thrombocytopenia, anemia, diarrhea, nausea, upper respiratory tract infection, cough, musculoskeletal pain, fatigue, edema
Most common (>=30%) in AML Nausea, diarrhea, thrombocytopenia, constipation, neutropenia, febrile neutropenia, fatigue, vomiting, edema, pyrexia, pneumonia, dyspnea, hemorrhage, anemia, rash, abdominal pain, sepsis, musculoskeletal pain, dizziness, cough, oropharyngeal pain, hypotension
Serious Tumor lysis syndrome, febrile neutropenia, pneumonia, sepsis, hemorrhage
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.
BCL-2 inhibitor; venetoclax is a selective, orally bioavailable small-molecule that restores apoptosis by binding directly to the BCL-2 protein, displacing pro-apoptotic proteins like BIM and triggering mitochondrial outer membrane permeabilization and activation of caspases.
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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)
Venclexta
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Trisenox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Venclexta
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Trisenox
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Venclexta
- 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 Venclexta.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.