| Multiple Myeloma
Xgeva vs Elrexfio
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Xgeva 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 Xgeva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Elrexfio but not Xgeva, including UnitedHealthcare
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Category
Xgeva
Elrexfio
At A Glance
SC injection
Every 4 weeks
RANKL inhibitor
SC injection
Weekly to every 4 weeks
BCMA-directed T-cell engager
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 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
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
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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%) 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
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.
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
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
Elrexfio
- Covered on 5 commercial plans
- PA (9/12) · 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)
Elrexfio
- 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)
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
No savings programs available for Xgeva.
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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ElrexfioView full Elrexfio profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.