What is Xgeva?
Xgeva (denosumab) is a monoclonal antibody injection that blocks RANKL, a protein involved in bone breakdown. It prevents osteoclast activity, reducing bone resorption. The FDA approved it in 2010 for adults with solid tumors and bone metastases to delay skeletal-related events like fractures or spinal cord compression.[1]
How is Xgeva administered?
Doctors give Xgeva as a 120 mg subcutaneous injection every 4 weeks, typically in the upper arm, upper thigh, or abdomen. No loading doses are needed, and it requires refrigeration.[1]
What conditions does Xgeva treat?
Xgeva treats bone complications from bone metastases in solid tumors (e.g., breast, prostate, lung cancers). It also prevents fracture risk in multiple myeloma patients. It differs from Prolia (also denosumab), which uses a 60 mg dose for osteoporosis in non-cancer patients.[1][2]
How does Xgeva differ from similar drugs like Zometa?
Xgeva offers convenience over Zometa (zoledronic acid), an IV bisphosphonate given every 3-4 weeks that requires hydration and monitoring for kidney issues. Xgeva has a lower risk of nephrotoxicity but carries a rare jaw osteonecrosis risk. Clinical trials showed Xgeva delayed skeletal events longer in some cancers.[1][3]
What are common Xgeva side effects?
Patients report low blood calcium (hypocalcemia), fatigue, nausea, and diarrhea. Serious risks include osteonecrosis of the jaw (ONJ), atypical femur fractures, and severe hypocalcemia. Dental checks are advised before starting.[1]
Who makes Xgeva and what is the pricing?
Amgen manufactures and markets Xgeva. List prices average $2,000-$3,000 per monthly dose in the US, varying by pharmacy and insurance. Patient assistance programs exist for eligible uninsured patients.[1][4]
When does Xgeva's patent expire?
Key US patents for denosumab expired around 2025, with some formulation patents extending to 2030. No biosimilars are approved yet, but challenges are ongoing. Check DrugPatentWatch.com for latest expiry details and litigation.5
[1]: https://www.xgeva.com
[2]: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-denosumab-bone-complications-multiple-myeloma
[3]: https://www.nejm.org/doi/full/10.1056/NEJMoa0910630
[4]: https://www.goodrx.com/xgeva