Rylaze (asparaginase erwinia chrysanthemi (recombinant)-rywn) vs Ezharmia (valemetostat tosilate)

Rylaze (asparaginase erwinia chrysanthemi (recombinant)-rywn) vs Ezharmia (valemetostat tosilate)

Rylaze is an asparagine-specific enzyme used as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) in patients who have developed hypersensitivity to E. coli-derived asparaginase. Valemetostat tosilate (Ezharmia) is an investigational, orally administered, selective inhibitor of the EZH1 and EZH2 histone methyltransferases, potentially used for the treatment of various hematological malignancies and solid tumors. When deciding between these two medications, it is crucial to consider the specific type of cancer being treated, as Rylaze is specifically indicated for ALL with a known hypersensitivity to E. coli-derived asparaginase, while Ezharmia is being explored for a broader range of malignancies and is not yet approved for any indication.

Difference between Rylaze and Ezharmia

Metric Rylaze (asparaginase erwinia chrysanthemi (recombinant)-rywn) Ezharmia (valemetostat tosilate)
Generic name Asparaginase erwinia chrysanthemi (recombinant)-rywn Valemetostat tosilate
Indications Acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma T-cell lymphoma
Mechanism of action Hydrolyzes asparagine to aspartic acid and ammonia, reducing circulating levels of asparagine, which leukemic cells cannot synthesize EZH2 inhibitor, altering gene expression and exhibiting antitumor activity
Brand names Rylaze Ezharmia
Administrative route Intramuscular injection Oral
Side effects Hypersensitivity, pancreatitis, thrombosis, bleeding, hyperglycemia, etc. Thrombocytopenia, neutropenia, anemia, gastrointestinal symptoms, etc.
Contraindications Hypersensitivity to asparaginase or any component of the formulation Not well-defined due to the novelty of the drug, but likely includes hypersensitivity to valemetostat or any component of the formulation
Drug class Antineoplastic agent, enzyme Epigenetic modifier, EZH2 inhibitor
Manufacturer Jazz Pharmaceuticals Daiichi Sankyo

Efficacy

Rylaze (Asparaginase Erwinia Chrysanthemi (Recombinant)-rywn) Efficacy in Lymphoma

Rylaze, known generically as asparaginase erwinia chrysanthemi (recombinant)-rywn, is a medication used in the treatment of acute lymphoblastic leukemia (ALL), a type of lymphoma. It is specifically indicated for patients who have developed hypersensitivity to E. coli-derived asparaginase. Rylaze functions by depleting the amino acid asparagine, which is necessary for the growth of leukemia cells. By depriving these cells of asparagine, Rylaze effectively inhibits their ability to proliferate. Clinical trials have demonstrated that Rylaze maintains nadir serum asparaginase activity levels above the threshold believed necessary for efficacy in ALL treatment when administered intramuscularly every 48 hours or every 72 hours.

The efficacy of Rylaze was primarily evaluated in a study of patients with ALL or lymphoblastic lymphoma who were either hypersensitive to E. coli-derived asparaginase or had experienced silent inactivation. The results showed that Rylaze provided the necessary asparaginase activity levels in the majority of patients, indicating its effectiveness in this setting. The drug's efficacy was assessed based on the achievement and maintenance of nadir serum asparaginase activity above the level of 0.1 U/mL, a threshold associated with good treatment outcomes in patients with ALL.

Ezharmia (Valemetostat Tosilate) Efficacy in Lymphoma

Ezharmia, with the generic name valemetostat tosilate, is an investigational drug that has shown promise in the treatment of certain types of lymphoma, specifically adult T-cell leukemia/lymphoma (ATLL) and peripheral T-cell lymphoma (PTCL). Valemetostat tosilate is a dual inhibitor of EZH1 and EZH2, which are enzymes that play a role in the epigenetic regulation of gene expression. By inhibiting these enzymes, Ezharmia can potentially alter the expression of genes that are involved in the growth and survival of lymphoma cells.

Although Ezharmia is still under investigation and has not yet been approved for general use, early clinical trials have reported some efficacy in patients with relapsed or refractory ATLL and PTCL. The drug has demonstrated a manageable safety profile and some antitumor activity, with a portion of patients achieving partial or complete responses. However, as with any investigational drug, further studies are required to fully establish the efficacy and safety profile of Ezharmia for the treatment of lymphoma and to potentially secure regulatory approval for its use in this indication.

Regulatory Agency Approvals

Rylaze
  • Food and Drug Administration (FDA), USA
Ezharmia
  • Pharmaceuticals and Medical Devices Agency (PMDA), Japan

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