| Multiple Myeloma
Xgeva vs Revlimid
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Xgeva vs Revlimid 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 signalsRevlimid has a higher rate of injection site reactions vs Xgeva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Revlimid but not Xgeva, including UnitedHealthcare
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Category
Xgeva
Revlimid
At A Glance
SC injection
Every 4 weeks
RANKL inhibitor
Oral
Daily on Days 1-21 of repeated 28-day cycles
Immunomodulatory agent targeting cereblon
Indications
- Multiple Myeloma
- Metastatic malignant neoplasm to bone
- Giant Cell Tumor of Bone
- Humoral hypercalcemia of malignancy (disorder)
- Multiple Myeloma
- Myelodysplastic Syndrome with Isolated del(5q)
- Mantle cell lymphoma
- Lymphoma, Follicular
- Marginal Zone B-Cell Lymphoma
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 (combination therapy) 25 mg orally once daily on Days 1-21 of repeated 28-day cycles, in combination with dexamethasone
Multiple Myeloma (maintenance therapy following auto-HSCT) 10 mg orally once daily continuously on Days 1-28 of repeated 28-day cycles
Myelodysplastic Syndrome with Isolated del(5q) 10 mg orally once daily
Mantle cell lymphoma 25 mg orally once daily on Days 1-21 of repeated 28-day cycles
Follicular Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
Marginal Zone B-Cell Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
Contraindications
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
- Pregnancy
- Severe hypersensitivity to lenalidomide including angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis
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%) - Multiple Myeloma combination therapy Diarrhea, anemia, constipation, peripheral edema, neutropenia, fatigue, back pain, nausea, asthenia, insomnia
Most common (>=20%) - Multiple Myeloma maintenance therapy Neutropenia, thrombocytopenia, leukopenia, anemia, upper respiratory tract infection, bronchitis, diarrhea, rash, fatigue
Most common (>=20%) - Myelodysplastic Syndromes Thrombocytopenia, neutropenia, pruritus, rash, diarrhea, constipation, nausea, nasopharyngitis, cough, dyspnea, pharyngitis, epistaxis, fatigue, pyrexia, peripheral edema, asthenia, arthralgia, back pain, muscle cramp
Most common (>=20%) - Mantle Cell Lymphoma Neutropenia, thrombocytopenia, anemia, fatigue, diarrhea, nausea, cough, dyspnea, rash, pruritus
Most common (>=20%) - Follicular and Marginal Zone Lymphoma Neutropenia, fatigue, diarrhea, constipation, nausea, cough
Serious Venous thromboembolism, arterial thromboembolism, infections including pneumonia, second primary malignancies, hepatotoxicity, severe cutaneous reactions, tumor lysis syndrome, tumor flare reactions
Postmarketing Hypothyroidism, hyperthyroidism, hepatic failure, toxic hepatitis, angioedema, anaphylaxis, acute graft-versus-host disease, viral reactivation, progressive multifocal leukoencephalopathy, pneumonitis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms
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.
Lenalidomide is an immunomodulatory agent that mediates cellular activities through binding to cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex, leading to degradation of substrate proteins and resulting in direct cytotoxic and immunomodulatory effects.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
Revlimid
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Xgeva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Revlimid
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (7/8)
Humana
Xgeva
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Revlimid
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Xgeva.
No savings programs available for Revlimid.
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RevlimidView full Revlimid profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.