Inqovi (decitabine and cedazuridine) vs Xospata (gilteritinib)

Inqovi (decitabine and cedazuridine) vs Xospata (gilteritinib)

Inqovi (decitabine and cedazuridine) is an oral hypomethylating agent used for the treatment of adults with myelodysplastic syndromes (MDS), including certain types of chronic myelomonocytic leukemia (CMML). Xospata (gilteritinib) is an oral FLT3 inhibitor specifically indicated for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with an FLT3 mutation. The choice between Inqovi and Xospata would depend on the specific diagnosis and genetic characteristics of the leukemia, as Inqovi is not appropriate for AML with FLT3 mutations, and Xospata is targeted for use in that specific AML subtype.

Difference between Inqovi and Xospata

Metric Inqovi (decitabine and cedazuridine) Xospata (gilteritinib)
Generic name Decitabine and cedazuridine Gilteritinib
Indications Myelodysplastic syndromes (MDS), including previously treated and untreated, de novo and secondary MDS with the following French-American-British subtypes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, and chronic myelomonocytic leukemia (CMML) Acute myeloid leukemia (AML) with a FLT3 mutation as detected by an FDA-approved test, in adults with relapsed or refractory disease
Mechanism of action Decitabine is a nucleoside metabolic inhibitor that inhibits DNA methyltransferase, leading to hypomethylation of DNA and cedazuridine is a cytidine deaminase inhibitor Gilteritinib is a kinase inhibitor that targets FLT3/AXL, which can help to inhibit the proliferation of leukemia cells
Brand names Inqovi Xospata
Administrative route Oral Oral
Side effects Fatigue, constipation, hemorrhage, myalgia, mucositis, arthralgia, nausea, dyspnea, diarrhea, rash, dizziness, febrile neutropenia, edema, headache, cough, decreased appetite, upper respiratory tract infection, pneumonia, and transaminase increased Myalgia, fatigue, nausea, diarrhea, dyspnea, edema, rash, dizziness, febrile neutropenia, cough, constipation, and changes in liver enzymes
Contraindications Hypersensitivity to decitabine, cedazuridine, or any component of the formulation Hypersensitivity to gilteritinib or any component of the formulation
Drug class Hypomethylating agent, Cytidine deaminase inhibitor Kinase inhibitor
Manufacturer Astellas Pharma US, Inc. Astellas Pharma US, Inc.

Efficacy

Inqovi (decitabine and cedazuridine) for Leukemia

Inqovi, a combination of decitabine and cedazuridine, is an oral hypomethylating agent approved for the treatment of adult patients with myelodysplastic syndromes (MDS), including previously treated and untreated, de novo and secondary MDS with various French-American-British (FAB) classifications, and intermediate-1, intermediate-2, and high-risk International Prognostic Scoring System (IPSS) groups. MDS are a group of disorders considered to be a form of blood cancer that can lead to leukemia. The efficacy of Inqovi was demonstrated in clinical trials where it was shown to be effective in achieving complete remission or partial remission in a significant number of patients. This oral formulation provides a more convenient administration route compared to the intravenous form of decitabine, potentially improving patient compliance and quality of life.

Xospata (gilteritinib) for Acute Myeloid Leukemia (AML)

Xospata (gilteritinib) is a targeted therapy approved for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation as detected by an FDA-approved test. AML is a rapidly progressing cancer that starts in the bone marrow and results in an increased number of white blood cells in the bloodstream. The efficacy of Xospata was evaluated in clinical trials that demonstrated a significant response rate in patients with FLT3 mutations, including complete remission with full or partial recovery of blood counts. These results underscore the importance of genetic testing in the management of AML to identify patients who may benefit from targeted therapies like gilteritinib.

Both Inqovi and Xospata represent advances in the treatment of different forms of leukemia, addressing the need for more effective and convenient treatment options. Inqovi offers a new oral option for patients with MDS, potentially delaying the progression to AML, while Xospata provides a targeted treatment for AML patients with specific genetic mutations. The use of these drugs is a testament to the progress being made in the field of hematology-oncology, where personalized medicine is increasingly becoming the standard of care.

It is important for patients to discuss with their healthcare providers the potential benefits and risks of these medications. Ongoing research and clinical trials continue to refine the understanding of the efficacy and safety of Inqovi and Xospata, as well as their roles in the broader treatment landscape for leukemia. As with any medication, the decision to use these drugs should be made on an individual basis, taking into account the specific clinical scenario and patient preferences.

Regulatory Agency Approvals

Inqovi
  • Food and Drug Administration (FDA), USA
  • Health Canada
Xospata
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia

Access Inqovi or Xospata today

If Inqovi or Xospata are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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