| Ankylosing spondylitis
Acthar vs Cosentyx
Side-by-side clinical, coverage, and cost comparison for ankylosing spondylitis.Deep comparison between: Acthar vs Cosentyx with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsCosentyx has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Cosentyx but not Acthar, including UnitedHealthcare
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Category
Acthar
Cosentyx
At A Glance
IM or SC injection
Corticotropin analog
SC injection
Every 4 weeks
IL-17A antagonist
Indications
- Infantile Spasm
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Lupus Erythematosus, Systemic
- Dermatomyositis
- Polymyositis
- Erythema Multiforme
- Stevens-Johnson Syndrome
- Serum Sickness
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis, Posterior
- Choroiditis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Psoriasis vulgaris
- Arthritis, Psoriatic
- Ankylosing spondylitis
- Non-Radiographic Axial Spondyloarthritis
- Enthesitis-Related Arthritis
- Hidradenitis Suppurativa
Dosing
Infantile Spasm 150 U/m2/day IM divided into 75 U/m2 twice daily for 2 weeks, then taper over 2 weeks; Acthar Gel vial only -- do not use the pre-filled SelfJect injector.
Multiple Sclerosis 80-120 units IM or SC daily for 2-3 weeks for acute exacerbations; taper as needed.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Lupus Erythematosus, Systemic, Dermatomyositis, Polymyositis, Erythema Multiforme, Stevens-Johnson Syndrome, Serum Sickness, Keratitis, Iritis, Iridocyclitis, Uveitis, Posterior, Choroiditis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome 40-80 units IM or SC every 24-72 hours; individualize dosing based on disease severity and patient response; taper dose upon discontinuation.
Psoriasis vulgaris 300 mg SC at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; 150 mg may be acceptable for some adults; pediatric patients 6 years and older receive weight-based dosing on the same schedule.
Arthritis, Psoriatic 150 mg SC with or without a loading dose at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; may increase to 300 mg SC every 4 weeks if active disease persists; IV option: 6 mg/kg loading at Week 0, then 1.75 mg/kg every 4 weeks infused over 30 minutes.
Ankylosing spondylitis 150 mg SC with or without a loading dose at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; may increase to 300 mg SC every 4 weeks if active disease persists; IV option: 6 mg/kg loading at Week 0, then 1.75 mg/kg every 4 weeks infused over 30 minutes.
Non-Radiographic Axial Spondyloarthritis 150 mg SC with or without a loading dose at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; IV option: 6 mg/kg loading at Week 0, then 1.75 mg/kg every 4 weeks infused over 30 minutes.
Enthesitis-Related Arthritis Weight-based SC dosing for pediatric patients 4 years and older at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; 150 mg for patients >= 50 kg.
Hidradenitis Suppurativa 300 mg SC at Weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter; may increase to every 2 weeks in adults with inadequate response; pediatric patients 12 years and older receive weight-based dosing every 4 weeks.
Contraindications
- Intravenous administration
- Use in infants under 2 years of age with suspected congenital infections
- Concomitant live or live-attenuated vaccines during immunosuppressive doses of Acthar Gel
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of peptic ulcer
- Congestive heart failure
- Uncontrolled hypertension
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
- Sensitivity to proteins of porcine origin
- Previous serious hypersensitivity reaction to secukinumab or any excipient in COSENTYX
Adverse Reactions
Most common (>=5%) Infections, convulsions, hypertension, irritability, pyrexia (reported in infantile spasm trials at recommended dose)
Serious Cushing's syndrome, adrenal insufficiency upon withdrawal, elevated blood pressure, salt and water retention, hypokalemia, gastrointestinal perforation and bleeding, behavioral and mood disturbances, ophthalmic effects, decreased bone density, negative effects on growth and physical development
Postmarketing Anaphylaxis, necrotizing angitis, pancreatitis, intracranial hemorrhage, subdural hematoma, reversible brain shrinkage, vertebral compression fractures, insomnia, injection site reactions
Most common (>=1%) nasopharyngitis, diarrhea, upper respiratory tract infection, rhinitis, oral herpes, pharyngitis, urticaria, rhinorrhea
Serious infections (including serious infections and sepsis), inflammatory bowel disease (Crohn's disease and ulcerative colitis), neutropenia, anaphylaxis, angioedema
Postmarketing anaphylaxis, angioedema, systemic vasculitis, eczematous eruptions, cutaneous vasculitis, pyoderma gangrenosum, opportunistic infections including esophageal candidiasis, cytomegalovirus gastroenteritis/colitis, Pneumocystis jiroveci pneumonia, hepatitis B virus reactivation, histoplasmosis, toxoplasmosis
Pharmacology
Repository corticotropin (ACTH) analog that stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and weak androgens; also reported to bind melanocortin receptors, with the trophic effects on the adrenal cortex appearing to be mediated by cyclic AMP.
Secukinumab is a human IgG1 monoclonal antibody that selectively binds to the IL-17A cytokine and inhibits its interaction with the IL-17 receptor, suppressing the release of proinflammatory cytokines and chemokines involved in inflammatory and immune responses.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Acthar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
Cosentyx
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Cosentyx
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (1/8) · Qty limit (4/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Cosentyx
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
Cost estimate not availableAssistance Fund: Ankylosing Spondylitis: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.