| Multiple Myeloma
Velcade vs Xgeva
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Velcade 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 Velcade based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xgeva but not Velcade, including UnitedHealthcare
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Category
Velcade
Xgeva
At A Glance
SC or IV injection
Twice weekly
Proteasome inhibitor
SC injection
Every 4 weeks
RANKL inhibitor
Indications
- Multiple Myeloma
- Carcinoma in situ of other and unspecified small intestine NOS
- Multiple Myeloma
- Metastatic malignant neoplasm to bone
- Giant Cell Tumor of Bone
- Humoral hypercalcemia of malignancy (disorder)
Dosing
Multiple Myeloma 1.3 mg/m2 SC or IV; previously untreated: twice weekly (Days 1, 4, 8, 11) in cycles 1-4 then once weekly (Days 1, 8, 22, 29) in cycles 5-9 with melphalan and prednisone for 9 six-week cycles; relapsed: twice weekly (Days 1, 4, 8, 11) every 3 weeks as single agent or with dexamethasone.
Carcinoma in situ of other and unspecified small intestine NOS 1.3 mg/m2 IV twice weekly (Days 1, 4, 8, 11) for 2 weeks followed by a 10-day rest period, in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (VcR-CAP) for 6 three-week cycles.
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
- Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
- Intrathecal administration
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
Adverse Reactions
Most common (>=10%) Nausea, diarrhea, fatigue, peripheral neuropathies, thrombocytopenia, vomiting, constipation, pyrexia, anorexia, anemia, headache, neutropenia, rash, paresthesia, dizziness, weakness
Serious Diarrhea, vomiting, pyrexia, nausea, dehydration, thrombocytopenia, pneumonia, dyspnea, peripheral neuropathies, herpes zoster
Postmarketing Cardiac tamponade, bilateral deafness, optic neuropathy, blindness, ischemic colitis, progressive multifocal leukoencephalopathy, herpes meningoencephalitis, posterior reversible encephalopathy syndrome, Guillain-Barre syndrome, demyelinating polyneuropathy, acute diffuse infiltrative pulmonary disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, acute febrile neutrophilic dermatosis
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
Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells; inhibition of this pathway disrupts homeostatic proteolysis, affecting multiple signaling cascades and leading to cell death in various cancer cell types including multiple myeloma.
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
Velcade
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Velcade
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xgeva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Velcade
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
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
No savings programs available for Velcade.
No savings programs available for Xgeva.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.