| Arthritis, Psoriatic
Acthar vs Rinvoq
Side-by-side clinical, coverage, and cost comparison for arthritis, psoriatic.Deep comparison between: Acthar vs Rinvoq 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 signalsRinvoq has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rinvoq but not Acthar, including UnitedHealthcare
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Category
Acthar
Rinvoq
At A Glance
IM or SC injection
Corticotropin analog
Oral
Once daily or twice daily (pediatric oral solution)
JAK inhibitor
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
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Dermatitis, Atopic
- Ulcerative Colitis
- Crohn Disease
- Ankylosing spondylitis
- Non-Radiographic Axial Spondyloarthritis
- Juvenile polyarthritis
- Giant Cell Arteritis
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.
Rheumatoid Arthritis 15 mg orally once daily
Arthritis, Psoriatic - Adults 15 mg orally once daily
Arthritis, Psoriatic - Pediatric 2 to <18 years Dosing based on weight: 10-<20 kg: 3 mg oral solution twice daily; 20-<30 kg: 4 mg oral solution twice daily; >=30 kg: 6 mg oral solution twice daily or 15 mg tablet once daily
Dermatitis, Atopic - Adults <65 years 15 mg orally once daily; may increase to 30 mg once daily if inadequate response
Dermatitis, Atopic - Adults >=65 years 15 mg orally once daily
Ulcerative Colitis - Induction 45 mg orally once daily for 8 weeks
Ulcerative Colitis - Maintenance 15 mg orally once daily; may use 30 mg once daily for refractory, severe, or extensive disease
Crohn Disease - Induction 45 mg orally once daily for 12 weeks
Crohn Disease - Maintenance 15 mg orally once daily; may use 30 mg once daily for refractory, severe, or extensive disease
Ankylosing spondylitis 15 mg orally once daily
Non-Radiographic Axial Spondyloarthritis 15 mg orally once daily
Juvenile polyarthritis Dosing based on weight: 10-<20 kg: 3 mg oral solution twice daily; 20-<30 kg: 4 mg oral solution twice daily; >=30 kg: 6 mg oral solution twice daily or 15 mg tablet once daily
Giant Cell Arteritis 15 mg orally once daily in combination with tapering corticosteroids; may continue as monotherapy after corticosteroid discontinuation
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
- Known hypersensitivity to upadacitinib or any excipients
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 (>=3%) - Rheumatoid Arthritis Upper respiratory tract infection, nausea, cough, pyrexia
Most common (>=3%) - Atopic Dermatitis Upper respiratory tract infection, acne, herpes simplex, headache, increased blood creatine phosphokinase, cough, hypersensitivity, folliculitis, nausea, abdominal pain
Most common (>=3%) - Ulcerative Colitis Induction Upper respiratory tract infection, acne, increased blood creatine phosphokinase, neutropenia, rash, elevated liver enzymes, lymphopenia
Most common (>=3%) - Ulcerative Colitis Maintenance Upper respiratory tract infection, increased blood creatine phosphokinase, pyrexia, neutropenia, elevated liver enzymes, rash, herpes zoster, folliculitis, hypercholesterolemia, influenza, herpes simplex
Most common (>=3%) - Crohn Disease Induction Upper respiratory tract infection, anemia, acne, pyrexia, increased blood creatine phosphokinase, influenza, herpes simplex
Most common (>=3%) - Crohn Disease Maintenance Upper respiratory tract infection, pyrexia, herpes zoster, headache, acne, gastroenteritis, fatigue, increased blood creatine phosphokinase
Most common (>=5%) - Giant Cell Arteritis Upper respiratory tract infection, headache, fatigue, peripheral edema, cough, anemia, rash, herpes zoster, nausea
Serious Serious infections, opportunistic infections, tuberculosis, malignancies, major adverse cardiovascular events, thrombosis, gastrointestinal perforations, hypersensitivity reactions, eczema herpeticum
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.
Upadacitinib is a JAK inhibitor that modulates intracellular signaling by preventing JAK-mediated phosphorylation and activation of STATs, thereby influencing immune cell function and hematopoiesis.
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)
Rinvoq
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (11/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Rinvoq
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Rinvoq
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
Cost estimate not availableCo-Pay Relief Rheumatoid Arthritis Fund
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.