| Multiple Myeloma

Aphexda vs Kyprolis

Side-by-side clinical, coverage, and cost comparison for multiple myeloma.

Deep comparison between: Aphexda vs Kyprolis with Prescriber.AI

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

Coverage gaps3 major payers require step therapy for Kyprolis but not Aphexda, including UnitedHealthcare

Category

Aphexda

Kyprolis

At A Glance

RouteSC injection

FrequencyPer apheresis (up to 2 doses)

ClassCXCR4 inhibitor

RouteIV infusion

FrequencyOnce or twice weekly

ClassProteasome inhibitor

Indications

Multiple Myeloma

Multiple Myeloma

Dosing

Multiple Myeloma 1.25 mg/kg via slow SC injection 10 to 14 hours before first apheresis, following 4 days of filgrastim pretreatment; premedicate with diphenhydramine, an H2 blocker, and a leukotriene inhibitor 30 to 60 minutes before each dose; a second dose may be given 10 to 14 hours before a third apheresis if necessary.

Multiple Myeloma 20/70 mg/m2 IV once weekly as a 30-minute infusion on Days 1, 8, and 15 of each 28-day cycle (in combination with dexamethasone, daratumumab plus dexamethasone, or daratumumab and hyaluronidase-fihj plus dexamethasone); start at 20 mg/m2 on Cycle 1, Day 1, escalate to 70 mg/m2 on Cycle 1, Day 8 if tolerated.

Multiple Myeloma 20/56 mg/m2 IV twice weekly as a 30-minute infusion on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle (as monotherapy or in combination with dexamethasone, daratumumab plus dexamethasone, daratumumab and hyaluronidase-fihj plus dexamethasone, or isatuximab plus dexamethasone); start at 20 mg/m2 on Cycle 1, Days 1 and 2, escalate to 56 mg/m2 on Cycle 1, Day 8 if tolerated.

Multiple Myeloma 20/27 mg/m2 IV twice weekly as a 10-minute infusion on Days 1, 2, 8, 9, 15, and 16 (Cycles 1-12) or Days 1, 2, 15, and 16 (Cycle 13+) of each 28-day cycle (as monotherapy or in combination with lenalidomide and dexamethasone); start at 20 mg/m2 on Cycle 1, Days 1 and 2, escalate to 27 mg/m2 on Cycle 1, Day 8 if tolerated.

Contraindications

History of serious hypersensitivity reactions to motixafortide

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Drug Interactions

1079View drug interactions

1089View drug interactions

Adverse Reactions

Most common (>20%) Injection site reactions (pain, erythema, pruritus), pruritus, flushing, back pain

Serious Vomiting, injection site reaction, hypersensitivity reaction, injection site cellulitis, hypokalemia, hypoxia

Most common (>=20%) Anemia, diarrhea, hypertension, fatigue, upper respiratory tract infection, thrombocytopenia, pyrexia, cough, dyspnea, insomnia

Serious Cardiac toxicities, acute renal failure, tumor lysis syndrome, pulmonary toxicity, pulmonary hypertension, venous thrombosis, infusion-related reactions, hemorrhage, hepatic toxicity and failure, thrombotic microangiopathy, posterior reversible encephalopathy syndrome, progressive multifocal leukoencephalopathy

Postmarketing Hemolytic uremic syndrome, hepatitis B virus reactivation, gastrointestinal perforation, pericarditis, cytomegalovirus infection

Pharmacology

Motixafortide is a CXCR4 inhibitor that blocks binding of SDF-1alpha/CXCL12 to CXCR4, disrupting stem cell anchoring in the bone marrow and mobilizing hematopoietic stem and progenitor cells into the peripheral circulation.

Carfilzomib is a tetrapeptide epoxyketone proteasome inhibitor that irreversibly binds to the N-terminal threonine-containing active sites of the 20S proteasome within the 26S proteasome, producing antiproliferative and proapoptotic effects in hematologic and solid tumor cells.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Aphexda