| Multiple Myeloma
Xgeva vs Aphexda
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Xgeva vs Aphexda 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 signalsAphexda has a higher rate of injection site reactions vs Xgeva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Aphexda but not Xgeva, including UnitedHealthcare
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Category
Xgeva
Aphexda
At A Glance
SC injection
Every 4 weeks
RANKL inhibitor
SC injection
Per apheresis (up to 2 doses)
CXCR4 inhibitor
Indications
- Multiple Myeloma
- Metastatic malignant neoplasm to bone
- Giant Cell Tumor of Bone
- Humoral hypercalcemia of malignancy (disorder)
- Multiple Myeloma
Dosing
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.
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.
Contraindications
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
- History of serious hypersensitivity reactions to motixafortide
Adverse Reactions
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
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
Pharmacology
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.
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.
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Most Common Insurance
Anthem BCBS
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
Aphexda
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Xgeva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Aphexda
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Xgeva
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Aphexda
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Xgeva.
$0
BioLineRx Connect Patient Assistance Program: AphexdaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.