| Arthritis, Psoriatic
Acthar vs Tremfya
Side-by-side clinical, coverage, and cost comparison for arthritis, psoriatic.Deep comparison between: Acthar vs Tremfya 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 signalsTremfya has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tremfya but not Acthar, including UnitedHealthcare
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Category
Acthar
Tremfya
At A Glance
IM or SC injection
Corticotropin analog
Subcutaneous / Intravenous
Every 4-8 weeks
Interleukin-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
- Ulcerative Colitis
- Crohn Disease
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 mg subcutaneous injection at Week 0, Week 4, and every 8 weeks thereafter. Pediatric patients >=6 years and >=40 kg: 100 mg subcutaneous injection at Week 0, Week 4, and every 8 weeks thereafter.
Arthritis, Psoriatic Adults: 100 mg subcutaneous injection at Week 0, Week 4, and every 8 weeks thereafter, alone or with conventional DMARD. Pediatric patients >=6 years and >=40 kg: 100 mg subcutaneous injection at Week 0, Week 4, and every 8 weeks thereafter, alone or with conventional DMARD.
Ulcerative Colitis Induction: 200 mg intravenous infusion over at least one hour at Week 0, 4, and 8, or 400 mg subcutaneous injection at Week 0, 4, and 8. Maintenance: 100 mg subcutaneous injection at Week 16 and every 8 weeks thereafter, or 200 mg subcutaneous injection at Week 12 and every 4 weeks thereafter.
Crohn Disease Induction: 200 mg intravenous infusion over at least one hour at Week 0, 4, and 8, or 400 mg subcutaneous injection at Week 0, 4, and 8. Maintenance: 100 mg subcutaneous injection at Week 16 and every 8 weeks thereafter, or 200 mg subcutaneous injection at Week 12 and every 4 weeks thereafter.
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
- History of serious hypersensitivity reaction to guselkumab or to any of the 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 (>=1%) Upper respiratory infections (14.3%), headache (4.6%), injection site reactions (4.5%), arthralgia (2.7%), diarrhea (1.6%), gastroenteritis (1.3%), tinea infections (1.1%), herpes simplex infections (1.1%).
Serious Serious infections occurred in <=0.2% in plaque psoriasis trials through Week 16. In ulcerative colitis trials, serious infections occurred in 0.8% with TREMFYA vs. 0% with placebo (44-week trial) and 1.8% vs. 0.7% (24-week trial). In Crohn's disease, serious infections occurred in 1.5% with TREMFYA vs. 0% with placebo.
Postmarketing Hypersensitivity including anaphylaxis, rash.
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.
Guselkumab is a human monoclonal IgG1 lambda antibody that selectively binds to the p19 subunit of interleukin-23 (IL-23) and inhibits its interaction with the IL-23 receptor, thereby inhibiting the release of proinflammatory cytokines and chemokines.
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)
Tremfya
- 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)
Tremfya
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (5/8) · Qty limit (5/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Tremfya
- 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 availableAssistance Fund: Psoriatic Arthritis
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.