| Lymphoma, Follicular

Brukinsa vs Epkinly

Side-by-side clinical, coverage, and cost comparison for lymphoma, follicular.

Deep comparison between: Brukinsa vs Epkinly with Prescriber.AI

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

Coverage gaps3 major payers require step therapy for Epkinly but not Brukinsa, including UnitedHealthcare

Category

Brukinsa

Epkinly

At A Glance

RouteOral

FrequencyOnce or twice daily

ClassBTK inhibitor

RouteSC injection

FrequencyEvery 1-4 weeks

ClassCD20xCD3 bispecific antibody

Indications

Mantle cell lymphoma
Waldenstrom Macroglobulinemia
Marginal Zone B-Cell Lymphoma
Chronic Lymphocytic Leukemia
Small Lymphocytic Lymphoma
Lymphoma, Follicular

Diffuse Large B-Cell Lymphoma
High grade B-cell lymphoma
Lymphoma, Follicular

Dosing

Mantle cell lymphoma, Waldenstrom Macroglobulinemia, Marginal Zone B-Cell Lymphoma, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma 160 mg orally twice daily or 320 mg orally once daily, with or without food, until disease progression or unacceptable toxicity.

Lymphoma, Follicular 160 mg orally twice daily in combination with obinutuzumab, with or without food, until disease progression or unacceptable toxicity.

Diffuse Large B-Cell Lymphoma, High grade B-cell lymphoma Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8); then 48 mg weekly through Cycle 3; 48 mg every 2 weeks for Cycles 4-9; 48 mg monthly from Cycle 10 until disease progression or unacceptable toxicity.

Lymphoma, Follicular (monotherapy) Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8), 3 mg (Day 15); then 48 mg weekly through Cycle 3; 48 mg every 2 weeks for Cycles 4-9; 48 mg monthly from Cycle 10 until disease progression or unacceptable toxicity.

Lymphoma, Follicular (+ lenalidomide and rituximab) Step-up SC doses: 0.16 mg (Day 1), 0.8 mg (Day 8), 3 mg (Day 15); then 48 mg weekly through Cycle 3; 48 mg monthly for Cycles 4-12 with lenalidomide 20 mg (Days 1-21) and rituximab 375 mg/m2 (Cycles 1-5); total 12 cycles or until progression.

Contraindications

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Drug Interactions

1014View drug interactions

694View drug interactions

Adverse Reactions

Most common (>=30%) Neutrophil count decreased, platelet count decreased, upper respiratory tract infection, hemorrhage, musculoskeletal pain

Serious Hemorrhage, pneumonia, cytopenias, second primary malignancies, cardiac arrhythmias, hepatotoxicity including drug-induced liver injury

Postmarketing Drug-induced liver injury

Most common (>=20%) CRS, fatigue, injection site reactions, musculoskeletal pain, pyrexia, abdominal pain, nausea, diarrhea, rash, upper respiratory tract infections, constipation, pneumonia, COVID-19, fever, cough, headache

Serious CRS, infections (sepsis, COVID-19, pneumonia, upper respiratory tract infections), pleural effusion, febrile neutropenia, fever, ICANS

Postmarketing Hemophagocytic Lymphohistiocytosis (HLH)

Pharmacology

Zanubrutinib is a small-molecule inhibitor of Bruton's tyrosine kinase (BTK) that forms a covalent bond with a cysteine residue in the BTK active site, inhibiting BTK activity and thereby blocking B-cell proliferation, trafficking, chemotaxis, and adhesion pathways driven by B-cell antigen receptor and cytokine receptor signaling.

Epcoritamab-bysp is a bispecific CD20-directed CD3 T-cell engager (humanized IgG1) that simultaneously binds CD3 on T-cells and CD20 on lymphoma and healthy B-lineage cells, activating T-cells, inducing cytokine release, and causing B-cell lysis; in combination with rituximab it also mediates NK cell antibody-dependent cellular cytotoxicity (ADCC).

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Brukinsa