| Multiple Myeloma
Darzalex Faspro vs Elrexfio
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Darzalex Faspro vs Elrexfio 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 signalsElrexfio has a higher rate of injection site reactions vs Darzalex Faspro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Elrexfio but not Darzalex Faspro, including UnitedHealthcare
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Category
Darzalex Faspro
Elrexfio
At A Glance
SC injection
Weekly, then every 2 weeks, then every 4 weeks
CD38-directed monoclonal antibody
SC injection
Weekly to every 4 weeks
BCMA-directed T-cell engager
Indications
- Multiple Myeloma
- Smoldering myeloma
- Light chain (AL) amyloidosis
- Multiple Myeloma
Dosing
Multiple Myeloma 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until disease progression. Dosing schedule varies by combination regimen (with lenalidomide-dexamethasone, bortezomib-melphalan-prednisone, bortezomib-thalidomide-dexamethasone, bortezomib-lenalidomide-dexamethasone, bortezomib-dexamethasone, pomalidomide-dexamethasone, or carfilzomib-dexamethasone) or as monotherapy.
Smoldering myeloma 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until diagnosis of multiple myeloma or maximum 3 years.
Light chain (AL) amyloidosis 1,800 mg daratumumab and 30,000 units hyaluronidase SC into abdomen over 3-5 minutes in combination with bortezomib-cyclophosphamide-dexamethasone. Weekly for 8 weeks, then every 2 weeks for 16 weeks, then every 4 weeks until disease progression or maximum 2 years.
Multiple Myeloma Step-up SC dosing: 12 mg on Day 1, 32 mg on Day 4, then 76 mg weekly starting Day 8 through week 24; for responders, transitions to 76 mg every 2 weeks (weeks 25-48), then 76 mg every 4 weeks (week 49 onward); continue until disease progression or unacceptable toxicity.
Contraindications
- Severe hypersensitivity to daratumumab, hyaluronidase, or any component of the formulation
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Adverse Reactions
Most common (>=20%) Upper respiratory tract infection, fatigue, peripheral neuropathy, musculoskeletal pain, constipation, diarrhea, insomnia, rash, edema, pyrexia, nausea, cough, dyspnea, sensory neuropathy, injection site reactions, infusion reactions, headache, decreased appetite, sleep disorder
Serious Pneumonia, cardiac failure, sepsis, thromboembolism, COVID-19, neutropenia, thrombocytopenia, arrhythmia, cardiac arrest, herpes zoster, hepatitis B reactivation, cytomegalovirus infection, listeriosis, atrial fibrillation, pancreatitis, pulmonary edema, anaphylactic reaction
Most common (>=20%) CRS, fatigue, injection site reaction, diarrhea, upper respiratory tract infection, musculoskeletal pain, pneumonia, decreased appetite, rash, cough, nausea, pyrexia
Serious Pneumonia, sepsis, CRS, upper respiratory tract infection, acute kidney injury, urinary tract infection, COVID-19, encephalopathy, pyrexia, febrile neutropenia
Pharmacology
Daratumumab is a CD38-directed IgG1 kappa monoclonal antibody that induces tumor cell death through multiple immune-mediated mechanisms including complement-dependent cytotoxicity, antibody-dependent cell-mediated cytotoxicity, antibody-dependent cellular phagocytosis, and direct apoptosis via Fc-mediated crosslinking.
Elranatamab-bcmm is a bispecific BCMA-directed CD3 T-cell engaging antibody that simultaneously binds BCMA on plasma cells, plasmablasts, and multiple myeloma cells and CD3 on T-cells, leading to T-cell activation and cytolysis of BCMA-expressing cells.
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Most Common Insurance
Anthem BCBS
Darzalex Faspro
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
Elrexfio
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Darzalex Faspro
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Elrexfio
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Darzalex Faspro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Elrexfio
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Amyloidosis
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Darzalex FasproView full Darzalex Faspro profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.