Inqovi (decitabine and cedazuridine) vs Brukinsa (zanubrutinib)

Inqovi (decitabine and cedazuridine) vs Brukinsa (zanubrutinib)

Inqovi (decitabine and cedazuridine) is an oral hypomethylating agent approved for the treatment of adults with myelodysplastic syndromes (MDS), including certain types of chronic myelomonocytic leukemia (CMML), which are conditions characterized by abnormal blood cells in the bone marrow. Brukinsa (zanubrutinib) is a Bruton's tyrosine kinase (BTK) inhibitor indicated for the treatment of mantle cell lymphoma (MCL), Waldenström's macroglobulinemia, and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), which are different types of B-cell malignancies. The choice between Inqovi and Brukinsa would depend on the specific type of blood or bone marrow disorder diagnosed, as they are not interchangeable and are used to treat distinct conditions.

Difference between Inqovi and Brukinsa

Metric Inqovi (decitabine and cedazuridine) Brukinsa (zanubrutinib)
Generic name Decitabine and cedazuridine Zanubrutinib
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) Mantle cell lymphoma (MCL) in adult patients who have received at least one prior therapy
Mechanism of action Decitabine is a hypomethylating agent that inhibits DNA methyltransferase, leading to DNA hypomethylation; cedazuridine is a cytidine deaminase inhibitor that increases the bioavailability of decitabine Bruton's tyrosine kinase (BTK) inhibitor that blocks the BTK signaling, which is necessary for the growth and survival of B cells
Brand names Inqovi Brukinsa
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 Cytopenias, diarrhea, rash, bruising, cough, and pneumonia
Contraindications Known hypersensitivity to decitabine or cedazuridine or any of their components None known specifically; however, caution should be used in patients with bleeding disorders, infection, cytopenias, and those undergoing surgery
Drug class Hypomethylating agent; DNA methyltransferase inhibitor Bruton's tyrosine kinase (BTK) inhibitor
Manufacturer Astellas Pharma US, Inc. BeiGene, Ltd.

Efficacy

Inqovi (decitabine and cedazuridine) Efficacy in Leukemia

Inqovi, which is a combination of decitabine and cedazuridine, is a medication approved for the treatment of adult patients with myelodysplastic syndromes (MDS), including previously treated and untreated, de novo and secondary MDS with the following French-American-British (FAB) subtypes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, and chronic myelomonocytic leukemia (CMML). MDS are a group of related blood disorders that are considered a form of cancer and can lead to leukemia. Clinical trials have shown that Inqovi is effective in inducing complete remission or complete remission with partial hematologic recovery in a significant portion of patients, which can be crucial in improving patient outcomes and delaying progression to acute myeloid leukemia (AML).

The efficacy of Inqovi was demonstrated in two phase 3 clinical trials, where it was compared to intravenous decitabine. The primary endpoint was the rate of complete remission (CR) and complete remission with partial hematologic improvement (CRi). Results indicated that Inqovi was effective in achieving these endpoints, with a comparable efficacy to intravenous decitabine. The oral administration of Inqovi offers a significant advantage in terms of patient convenience and quality of life, as it reduces the need for frequent hospital visits for intravenous treatment.

Brukinsa (zanubrutinib) Efficacy in Leukemia

Brukinsa (zanubrutinib) is a Bruton's tyrosine kinase (BTK) inhibitor approved for the treatment of mantle cell lymphoma (MCL) in adult patients who have received at least one prior therapy. While MCL is a type of non-Hodgkin's lymphoma and not leukemia, BTK inhibitors like zanubrutinib are being studied for their potential use in various types of B-cell leukemias, such as chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). In clinical trials, Brukinsa has shown promising efficacy in treating these conditions, with high response rates and durable remissions being observed in patients.

Though not yet approved specifically for leukemia, ongoing research and clinical trials are investigating the efficacy of Brukinsa in various leukemic conditions. Early results have been promising, suggesting that zanubrutinib may represent a new treatment option for patients with B-cell leukemias. The drug's mechanism of action, which involves selective inhibition of BTK, plays a critical role in the survival and proliferation of B cells, making it a targeted therapy with the potential to improve outcomes for patients with leukemia.

Regulatory Agency Approvals

Inqovi
  • Food and Drug Administration (FDA), USA
  • Health Canada
Brukinsa
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA

Access Inqovi or Brukinsa today

If Inqovi or Brukinsa 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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