Onureg

• Onureg (azacitidine tablets) is an oral chemotherapy drug used for the continued treatment of acute myeloid leukemia (AML).
• It works by targeting and inhibiting DNA and RNA synthesis in cancer cells, leading to their death.
• The medication is typically prescribed after initial induction chemotherapy to maintain remission.
• Common side effects include nausea, vomiting, diarrhea, fatigue, and low blood cell counts.
• Patients should adhere strictly to the prescribed dosage and schedule to maximize efficacy and manage potential adverse reactions.

What is Onureg and How Does It Work?

Onureg is an oral formulation of azacitidine, a nucleoside metabolic inhibitor. It is specifically approved for the continued treatment of adult patients with acute myeloid leukemia (AML) who achieved a first complete remission (CR) or complete remission with incomplete blood count recovery (CRi) following intensive induction chemotherapy, and who are not candidates for, or choose not to proceed to, hematopoietic stem cell transplantation. This medication plays a vital role in maintaining remission and preventing disease relapse in this patient population.

The mechanism of action for Onureg involves its incorporation into DNA and RNA, which are essential components for cell growth and division. Once incorporated, azacitidine interferes with the normal function of these nucleic acids. Specifically, it inhibits DNA methyltransferases, enzymes critical for DNA methylation, a process that can silence tumor suppressor genes. By reducing DNA methylation, Onureg can reactivate these genes, promoting cellular differentiation and apoptosis (programmed cell death) in leukemic cells. Additionally, its incorporation into RNA disrupts protein synthesis, further contributing to the anti-cancer effect. This dual action helps to control the proliferation of cancerous cells and maintain the patient’s remission.

Onureg Uses, Dosage, and Side Effects

Onureg medication information specifies its primary use in the maintenance therapy for AML patients. Following successful induction chemotherapy, patients who achieve remission often require ongoing treatment to prevent the return of the disease. Onureg provides an oral option for this critical maintenance phase, offering convenience compared to intravenous treatments. The typical recommended dosage for Onureg is 300 mg taken orally once daily for 14 consecutive days of a 28-day cycle. Treatment continues as long as the patient benefits and tolerates the medication, with dose adjustments possible based on individual response and the occurrence of adverse events. Adherence to the prescribed regimen is crucial for the effectiveness of the treatment.

Like most chemotherapy agents, Onureg can cause various Onureg side effects. These can range from mild to severe and often require careful management by the healthcare team. Common side effects include:

• Nausea and vomiting
• Diarrhea or constipation
• Fatigue and weakness
• Decreased appetite
• Abdominal pain
• Low blood cell counts (myelosuppression), such as anemia (low red blood cells), neutropenia (low white blood cells, increasing infection risk), and thrombocytopenia (low platelets, increasing bleeding risk).

Patients are closely monitored for these side effects through regular blood tests and clinical assessments. Severe side effects, particularly myelosuppression, may necessitate dose interruptions or reductions. It is imperative for patients to report any new or worsening symptoms to their doctor promptly. According to a study published in the New England Journal of Medicine (2020), the QUAZAR AML-001 trial demonstrated that patients receiving Onureg had a significantly longer overall survival compared to placebo, despite the observed side effects, highlighting its clinical benefit in this challenging disease.