What is the Difference Between Filgrastim and Lenograstim?

Filgrastim and Lenograstim are both recombinant forms of human granulocyte colony-stimulating factor (G-CSF) used to treat neutropenia, a condition characterized by an abnormally low number of neutrophils (a type of white blood cell) in the bloodstream. They have some differences in their structure and production:

• Production: Filgrastim is produced in E. coli expression systems and is a non-glycosylated molecule. Lenograstim, on the other hand, is produced in Chinese hamster cell lines and is a fully glycosylated molecule.
• Glycosylation: Lenograstim is a glycosylated form of G-CSF, which increases the receptor affinity of the protein to the corresponding receptor, creates a higher plasma half-life, and confers temperature resistance (no need for refrigeration).

Clinically, there are some differences between the two drugs:

• Efficacy: In a study comparing lenograstim and filgrastim in the febrile neutropenia prophylaxis of hospitalized patients, lenograstim demonstrated a lower incidence of febrile episodes compared to filgrastim. Additionally, a higher number of patients achieved the target dose of CD34+ cells during mobilization of autologous stem cells with lenograstim, and in a slightly shorter time, reducing the duration of neutropenia.
• Cost: The same study found that a higher number of filgrastim vials (11 vs 7) were necessary to obtain full bone marrow recovery, which led to a higher final cost per patient.

Another study suggested that lenograstim and filgrastim are equivalent for peripheral blood stem cell (PBSC) mobilization after chemotherapy.

Comparative Table: Filgrastim vs Lenograstim

Filgrastim and lenograstim are both recombinant human granulocyte colony-stimulating factors (G-CSF) used to treat neutropenia, a condition characterized by a low number of white blood cells. They are produced using recombinant DNA technology and are administered to patients by prolonged intravenous infusion or subcutaneous infusion. Here is a table summarizing the differences between filgrastim and lenograstim:

From a clinical point of view, lenograstim has demonstrated a lower incidence of febrile episodes compared to filgrastim, and it is able to preserve the functional status of neutrophils. Additionally, the use of lenograstim instead of filgrastim can lead to a decrease in direct medical costs related to inpatient care.