| Multiple Myeloma

Aphexda vs Pomalyst

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

Deep comparison between: Aphexda vs Pomalyst with Prescriber.AI

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

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

Category

Aphexda

Pomalyst

At A Glance

RouteSC injection

FrequencyPer apheresis (up to 2 doses)

ClassCXCR4 inhibitor

RouteOral

FrequencyOnce daily, Days 1-21 of 28-day cycles

ClassThalidomide analogue (immunomodulatory)

Indications

Multiple Myeloma

Multiple Myeloma
Kaposi Sarcoma

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 4 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression; given in combination with dexamethasone.

Kaposi Sarcoma 5 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression or unacceptable toxicity; continue HAART as HIV treatment in patients with AIDS-related KS.

Contraindications

History of serious hypersensitivity reactions to motixafortide

Pregnancy
Severe hypersensitivity (e.g., angioedema, anaphylaxis) to pomalidomide or any excipient

Drug Interactions

1497View drug interactions

1413View 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 (>=10%) Neutropenia, anemia, fatigue/asthenia, constipation, nausea, diarrhea, dyspnea, upper respiratory tract infection, pneumonia, back pain, peripheral neuropathy, edema peripheral, pyrexia, thrombocytopenia, rash

Serious Venous and arterial thromboembolism, hematologic toxicity (neutropenia, thrombocytopenia, febrile neutropenia), hepatotoxicity, severe cutaneous reactions, pneumonia, sepsis, dizziness and confusional state, neuropathy, tumor lysis syndrome

Postmarketing Pancytopenia, hepatic failure, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, progressive multifocal leukoencephalopathy, hepatitis B virus reactivation, herpes zoster, tumor lysis syndrome, basal cell carcinoma, squamous cell carcinoma of the skin

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.

Pomalidomide is a thalidomide analogue with immunomodulatory, antiangiogenic, and antineoplastic properties; it acts through cereblon (a cullin ring E3 ubiquitin ligase component), targeting substrate proteins Aiolos and Ikaros for ubiquitination and degradation, producing direct cytotoxic and immunomodulatory effects including enhanced T cell- and NK cell-mediated immunity and inhibition of pro-inflammatory cytokines (TNF-alpha and IL-6).

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Aphexda