| Arthritis, Psoriatic

Acthar vs Stelara

Side-by-side clinical, coverage, and cost comparison for arthritis, psoriatic.

Deep comparison between: Acthar vs Stelara with Prescriber.AI

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Safety signalsStelara has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Stelara but not Acthar, including UnitedHealthcare

Category

Acthar

Stelara

At A Glance

RouteIM or SC injection

ClassCorticotropin analog

RouteSC injection

FrequencyEvery 8-12 weeks

ClassIL-12/23 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
Crohn Disease
Ulcerative Colitis

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 Adults <=100 kg: 45 mg SC at weeks 0 and 4, then every 12 weeks; adults >100 kg: 90 mg SC at weeks 0 and 4, then every 12 weeks; pediatric patients >=6 years: weight-based dosing (0.75 mg/kg for <60 kg, 45 mg for 60-100 kg, 90 mg for >100 kg) SC at weeks 0 and 4, then every 12 weeks.

Arthritis, Psoriatic Adults: 45 mg SC at weeks 0 and 4, then every 12 weeks (90 mg for >100 kg with co-existent moderate-to-severe plaque psoriasis); pediatric patients >=6 years: weight-based dosing (0.75 mg/kg for <60 kg, 45 mg for >=60 kg, 90 mg for >100 kg with co-existent plaque psoriasis) SC at weeks 0 and 4, then every 12 weeks.

Crohn Disease, Ulcerative Colitis Adults: single IV induction dose (260 mg for <=55 kg, 390 mg for >55-85 kg, 520 mg for >85 kg), followed by 90 mg SC at week 8, then every 8 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

Clinically significant hypersensitivity to ustekinumab or any excipient of STELARA

Drug Interactions

648View drug interactions

969View drug interactions

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, upper respiratory tract infection, headache, fatigue, back pain, dizziness, pharyngolaryngeal pain, pruritus, injection site erythema, myalgia, depression

Serious Infections, malignancies, serious hypersensitivity reactions, posterior reversible encephalopathy syndrome (PRES), noninfectious pneumonia

Postmarketing Hypersensitivity reactions (anaphylaxis, angioedema, dyspnea, rash, urticaria), lower respiratory tract infection, PRES, interstitial pneumonia, eosinophilic pneumonia, cryptogenic organizing pneumonia, pustular psoriasis, erythrodermic psoriasis, hypersensitivity vasculitis

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.

Ustekinumab is a human IgG1k monoclonal antibody that binds the p40 protein subunit shared by IL-12 and IL-23, blocking their interaction with the IL-12Rb1 receptor chain and thereby suppressing downstream inflammatory signaling involved in natural killer cell activation and CD4+ T-cell differentiation and activation.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Acthar