| Ankylosing spondylitis
Acthar vs Renflexis
Side-by-side clinical, coverage, and cost comparison for ankylosing spondylitis.Deep comparison between: Acthar vs Renflexis 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 signalsRenflexis has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Renflexis but not Acthar, including UnitedHealthcare
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Category
Acthar
Renflexis
At A Glance
IM or SC injection
Corticotropin analog
IV infusion
Every 6-8 weeks
TNF-alpha 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
- Crohn Disease
- Ulcerative Colitis
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Arthritis, Psoriatic
- Psoriasis vulgaris
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.
Crohn Disease, Ulcerative Colitis, Arthritis, Psoriatic, Psoriasis vulgaris 5 mg/kg IV induction at 0, 2, and 6 weeks, then 5 mg/kg every 8 weeks; pediatric patients >= 6 years with Crohn Disease or Ulcerative Colitis receive the same regimen.
Rheumatoid Arthritis 3 mg/kg IV induction at 0, 2, and 6 weeks, then 3 mg/kg every 8 weeks in combination with methotrexate; may increase up to 10 mg/kg every 8 weeks or every 4 weeks for incomplete response.
Ankylosing spondylitis 5 mg/kg IV induction at 0, 2, and 6 weeks, then 5 mg/kg every 6 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
- Doses >5 mg/kg in patients with moderate or severe heart failure
- Previous severe hypersensitivity reaction to infliximab products, any inactive ingredient of RENFLEXIS, or any murine proteins
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 (>10%) Infections (upper respiratory, sinusitis, pharyngitis), infusion-related reactions, headache, abdominal pain
Serious Serious infections (pneumonia, cellulitis, abscess, sepsis, tuberculosis), hepatotoxicity, malignancies, severe infusion reactions
Postmarketing Neutropenia, agranulocytosis, interstitial lung disease, Stevens-Johnson Syndrome, toxic epidermal necrolysis, acute liver failure, anaphylactic shock, cerebrovascular accidents, myocardial ischemia/infarction
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.
TNF-alpha antagonist; infliximab-abda is a chimeric IgG1kappa monoclonal antibody that neutralizes TNF-alpha by binding with high affinity to soluble and transmembrane forms of TNF-alpha, inhibiting receptor binding and suppressing downstream pro-inflammatory activity.
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)
Renflexis
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Renflexis
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Renflexis
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
No savings programs available for Renflexis.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.