| Leukemia, Myelocytic, Acute
Trisenox vs Xospata
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Trisenox vs Xospata 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 signalsXospata has a higher rate of injection site reactions vs Trisenox based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xospata but not Trisenox, including UnitedHealthcare
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Category
Trisenox
Xospata
At A Glance
Intravenous
Daily
Arsenical antineoplastic
Oral
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 120 mg orally once daily with or without food; in the absence of disease progression or unacceptable toxicity, treat for a minimum of 6 months to allow time for a clinical response.
Contraindications
- Hypersensitivity to arsenic
- Hypersensitivity to gilteritinib or any of the excipients
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%) transaminase increased, myalgia/arthralgia, fatigue/malaise, fever, mucositis, edema, rash, noninfectious diarrhea, dyspnea, nausea, cough, constipation, eye disorders, headache, dizziness, hypotension, vomiting, renal impairment, abdominal pain, neuropathy, insomnia, dysgeusia
Serious differentiation syndrome, posterior reversible encephalopathy syndrome, prolonged QT interval, pancreatitis
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.
Gilteritinib is a small molecule inhibitor of multiple receptor tyrosine kinases, including FLT3; it inhibits FLT3 receptor signaling and proliferation in cells expressing FLT3-ITD and FLT3 tyrosine kinase domain mutations, and induces apoptosis in leukemic cells expressing FLT3-ITD.
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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)
Xospata
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (3/12) · Qty limit (12/12)
UnitedHealthcare
Trisenox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xospata
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Trisenox
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Xospata
- 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
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.