| Multiple Myeloma
Ninlaro vs Xgeva
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Xgeva 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 signalsXgeva has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xgeva but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Xgeva
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
SC injection
Every 4 weeks
RANKL inhibitor
Indications
- Multiple Myeloma
- Multiple Myeloma
- Metastatic malignant neoplasm to bone
- Giant Cell Tumor of Bone
- Humoral hypercalcemia of malignancy (disorder)
Dosing
Multiple Myeloma 4 mg orally once weekly on Days 1, 8, and 15 of a 28-day cycle in combination with lenalidomide 25 mg daily (Days 1-21) and dexamethasone 40 mg (Days 1, 8, 15, 22); reduce starting dose to 3 mg for moderate or severe hepatic impairment, severe renal impairment (CrCl <30 mL/min), or ESRD requiring dialysis.
Multiple Myeloma, Metastatic malignant neoplasm to bone 120 mg SC every 4 weeks in the upper arm, upper thigh, or abdomen.
Giant Cell Tumor of Bone, Humoral hypercalcemia of malignancy (disorder) 120 mg SC every 4 weeks with additional 120 mg doses on Days 8 and 15 of the first month of therapy, in the upper arm, upper thigh, or abdomen.
Contraindications
—
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
Adverse Reactions
Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis
Serious Diarrhea, thrombocytopenia, bronchitis
Postmarketing Angioedema, toxic epidermal necrolysis
Most common (>=25%) Fatigue/asthenia, hypophosphatemia, nausea
Serious Dyspnea, osteonecrosis of the jaw, hypocalcemia, atypical subtrochanteric and diaphyseal femoral fracture, multiple vertebral fractures following treatment discontinuation
Postmarketing Severe symptomatic hypocalcemia (including fatal cases), severe symptomatic hypercalcemia following treatment discontinuation, hypersensitivity including anaphylactic reactions, severe musculoskeletal pain, lichenoid drug eruptions, alopecia
Pharmacology
Ixazomib is a reversible proteasome inhibitor that preferentially binds and inhibits the chymotrypsin-like activity of the beta 5 subunit of the 20S proteasome, inducing apoptosis in multiple myeloma cell lines and demonstrating synergistic cytotoxic effects in combination with lenalidomide.
Xgeva is a RANKL inhibitor; it binds to RANKL, a protein essential for osteoclast formation, function, and survival, thereby preventing osteoclast-mediated bone resorption and modulating calcium release from bone in solid tumor bone metastases, multiple myeloma, giant cell tumor of bone, and hypercalcemia of malignancy.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Xgeva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ninlaro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Xgeva
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Xgeva.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.