| Multiple Myeloma
Xgeva vs Sarclisa
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Xgeva vs Sarclisa 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 signalsSarclisa has a higher rate of injection site reactions vs Xgeva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Sarclisa but not Xgeva, including UnitedHealthcare
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Category
Xgeva
Sarclisa
At A Glance
SC injection
Every 4 weeks
RANKL inhibitor
IV infusion
Every 1-4 weeks
CD38-directed cytolytic antibody
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 (with pomalidomide and dexamethasone) 10 mg/kg IV weekly in cycle 1 (days 1, 8, 15, 22 of a 28-day cycle), then every 2 weeks (days 1, 15) from cycle 2 onward.
Multiple Myeloma (with carfilzomib and dexamethasone) 10 mg/kg IV weekly in cycle 1, then every 2 weeks from cycle 2 onward.
Multiple Myeloma (with bortezomib, lenalidomide, and dexamethasone) 10 mg/kg IV on days 1, 8, 15, 22, and 29 of cycle 1 (42-day cycle); every 2 weeks in cycles 2-17; every 4 weeks from cycle 18 onward.
Contraindications
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
- Severe hypersensitivity to isatuximab-irfc or any of its excipients
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%) Upper respiratory tract infection, infusion-related reactions, pneumonia, diarrhea, fatigue, hypertension, dyspnea, insomnia, bronchitis, cough, back pain, peripheral sensory neuropathy, musculoskeletal pain, cataract, constipation, peripheral edema, rash
Serious Pneumonia, upper respiratory tract infections, febrile neutropenia, cardiac failure
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.
Isatuximab-irfc is an IgG1-derived monoclonal antibody that binds to CD38 expressed on hematopoietic and tumor cells, inducing apoptosis and activating immune effector mechanisms including ADCC, ADCP, and CDC, while also inhibiting CD38 ADP-ribosyl cyclase activity and suppressing CD38-positive T-regulatory 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)
Sarclisa
- 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)
Sarclisa
- 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)
Sarclisa
- Covered on 0 commercial plans
- PA (3/3) · 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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SarclisaView full Sarclisa profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.