| Arthritis, Psoriatic
Acthar vs Purified Cortrophin Gel
Side-by-side clinical, coverage, and cost comparison for arthritis, psoriatic.Deep comparison between: Acthar vs Purified Cortrophin Gel 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 signalsPurified Cortrophin Gel has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Purified Cortrophin Gel but not Acthar, including UnitedHealthcare
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Category
Acthar
Purified Cortrophin Gel
At A Glance
IM or SC injection
Corticotropin analog
SC/IM injection
Corticotropin (ACTH)
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
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Primary gout
- Lupus Erythematosus, Systemic
- Polymyositis
- Stevens-Johnson Syndrome
- Psoriasis
- Dermatitis, Atopic
- Serum Sickness
- Allergic Conjunctivitis
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Multiple Sclerosis
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.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Primary gout, Lupus Erythematosus, Systemic, Polymyositis, Stevens-Johnson Syndrome, Psoriasis, Dermatitis, Atopic, Serum Sickness, Allergic Conjunctivitis, Keratitis, Iritis, Iridocyclitis, Uveitis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome Dose individualized based on disease severity, plasma and urine corticosteroid levels, and patient response; administer SC or IM; verify adrenal responsiveness prior to treatment (up to 80 units as a single injection); chronic doses above 40 units daily associated with uncontrollable adverse effects.
Multiple Sclerosis 80-120 units daily SC or IM for 2-3 weeks for acute exacerbations.
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
- Intravenous administration
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of a peptic ulcer
- Congestive heart failure
- Hypertension
- Sensitivity to proteins derived from porcine sources
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
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
Fluid and Electrolyte Sodium retention, hypokalemic alkalosis, fluid retention, calcium loss, potassium loss
Musculoskeletal Muscle weakness, loss of muscle mass, steroid myopathy, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones
Gastrointestinal Peptic ulcer with possible perforation and hemorrhage, abdominal distention, ulcerative esophagitis, pancreatitis
Dermatologic Injection site reactions, impaired wound healing, increased sweating, thin fragile skin, suppression of skin test reactions, petechiae and ecchymoses, acne, hyperpigmentation, facial erythema
Cardiovascular Hypertension, congestive heart failure, necrotizing angiitis
Neurological Convulsions, increased intracranial pressure with papilledema, headache, vertigo
Endocrine Menstrual irregularities, Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary insufficiency, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents, hirsutism
Ophthalmic Posterior subcapsular cataracts, increased intraocular pressure, glaucoma with possible damage to optic nerve, exophthalmos
Metabolic Negative nitrogen balance due to protein catabolism
Allergic Dizziness, nausea and vomiting, skin reactions, anaphylaxis (anaphylactic shock, urticaria, respiratory compromise, edema)
Miscellaneous Weight gain, abscess, development of antibodies and loss of stimulatory effect
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.
Purified Cortrophin Gel is an anterior pituitary hormone (corticotropin/ACTH) that stimulates the functioning adrenal cortex to produce and secrete adrenocortical hormones; it is formulated as a porcine-derived purified ACTH in a sterile gelatin solution for prolonged 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)
Purified Cortrophin Gel
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Purified Cortrophin Gel
- Covered on 4 commercial plans
- PA (5/8) · 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)
Purified Cortrophin Gel
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
No savings programs available for Purified Cortrophin Gel.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.