Summary

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• Decitabine and cedazuridine (Inqovi) is indicated for the treatment of adult patients with myelodysplastic syndromes (MDS), including previously treated and untreated, de novo, and secondary MDS. It covers various French-American-British subtypes such as refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, chronic myelomonocytic leukemia [CMML], along with intermediate-1, intermediate-2, and high-risk International Prognostic Scoring System groups.
• Information about Inqovi was derived from one randomized controlled study.
• This drug has been tested on a population predominantly composed of white individuals (91%), with a majority being male (65%). The participants were adults 18 years or older suitable for intravenous decitabine therapy, including both previously untreated and treated individuals.
• When comparing safety profiles based on this single study's results: 61% of participants experienced thrombocytopenia; 57% experienced neutropenia; 50% experienced anemia. Serious adverse events during the first two cycles occurred more frequently among oral Inqovi users than those using intravenous decitabine, at rates of 31% versus 18%, respectively.
• Effectiveness comparisons between oral Inqovi and intravenous decitabine measured over five days within the first two treatment cycles showed they have equivalent pharmacokinetic properties. Oral administration may offer convenience benefits to individuals, potentially reducing healthcare visits, which could improve their quality of life during the treatment period.
• Despite these advantages offered by oral administration, it also necessitates careful monitoring due to a slightly higher incidence rate observed for serious adverse events initially when compared against its counterpart, intravenous decitabine usage.