| Juvenile polyarthritis

Actemra vs Hadlima

Side-by-side clinical, coverage, and cost comparison for juvenile polyarthritis.

Deep comparison between: Actemra vs Hadlima 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 signalsHadlima has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Hadlima but not Actemra, including UnitedHealthcare

Category

Actemra

Hadlima

At A Glance

RouteIV infusion or SC injection

FrequencyEvery 4 weeks (IV) or Every week to Every other week (SC)

ClassIL-6 receptor antagonist

RouteSC injection

FrequencyEvery other week

ClassTNF-alpha blocker

Indications

Rheumatoid Arthritis
Giant Cell Arteritis
Lung disease with systemic sclerosis
Juvenile polyarthritis
Systemic onset juvenile chronic arthritis
Cytokine Release Syndrome
COVID-19 Virus Disease

Rheumatoid Arthritis
Juvenile polyarthritis
Arthritis, Psoriatic
Ankylosing spondylitis
Crohn Disease
Ulcerative Colitis
Psoriasis vulgaris
Hidradenitis Suppurativa
Uveitis

Dosing

Rheumatoid Arthritis IV: 4 mg/kg every 4 weeks, increase to 8 mg/kg every 4 weeks based on response; SC: 162 mg every other week (for <100 kg) or every week (for >=100 kg), increase to every week based on response.

Giant Cell Arteritis IV: 6 mg/kg every 4 weeks with tapering glucocorticoids; SC: 162 mg every week with tapering glucocorticoids (may use every other week based on clinical considerations).

Systemic Sclerosis-Associated Interstitial Lung Disease SC: 162 mg every week.

Polyarticular Juvenile Idiopathic Arthritis IV: 10 mg/kg every 4 weeks (<30 kg) or 8 mg/kg every 4 weeks (>=30 kg); SC: 162 mg every 3 weeks (<30 kg) or every 2 weeks (>=30 kg).

Systemic Juvenile Idiopathic Arthritis IV: 12 mg/kg every 2 weeks (<30 kg) or 8 mg/kg every 2 weeks (>=30 kg); SC: 162 mg every 2 weeks (<30 kg) or every week (>=30 kg).

Cytokine Release Syndrome IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single dose, alone or with corticosteroids; up to 3 additional doses at least 8 hours apart if no improvement.

COVID-19 IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single 60-minute infusion; one additional dose at least 8 hours later if clinical signs worsen or do not improve.

Rheumatoid Arthritis, Arthritis, Psoriatic, Ankylosing spondylitis 40 mg SC every other week; some RA patients not receiving MTX may benefit from 40 mg every week or 80 mg every other week.

Juvenile polyarthritis SC every other week based on weight for patients 2 years and older: 10 mg (10 to <15 kg), 20 mg (15 to <30 kg), or 40 mg (>=30 kg).

Crohn Disease Adults: 160 mg Day 1, 80 mg Day 15, then 40 mg every other week starting Day 29; pediatric patients >=6 years: weight-based induction (80 or 160 mg Day 1, 40 or 80 mg Day 15), then 20 or 40 mg every other week starting Day 29.

Ulcerative Colitis 160 mg Day 1, 80 mg Day 15, then 40 mg every other week starting Day 29; discontinue if no clinical remission by Day 57.

Psoriasis vulgaris, Uveitis 80 mg initial dose, then 40 mg every other week starting 1 week after the initial dose.

Hidradenitis Suppurativa 160 mg Day 1, 80 mg Day 15, then 40 mg every week or 80 mg every other week starting Day 29.

Contraindications

Known hypersensitivity to tocilizumab

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Drug Interactions

856View drug interactions

1223View drug interactions

Adverse Reactions

Most common (>=5%) Upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions (SC only).

Serious Serious infections (pneumonia, urinary tract infection, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis, bacterial arthritis), gastrointestinal perforations, hypersensitivity reactions including anaphylaxis.

Postmarketing Fatal anaphylaxis, Stevens-Johnson Syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), pancreatitis, drug-induced liver injury, hepatitis, hepatic failure, jaundice, hypofibrinogenemia.

Most common (>=5%) Injection site reactions, upper respiratory infection, headache, rash, sinusitis, nausea, accidental injury, urinary tract infection, hyperlipidemia, flu syndrome, abdominal pain, laboratory test abnormalities.

Serious Serious infections (pneumonia, septic arthritis, erysipelas, cellulitis, diverticulitis, pyelonephritis), malignancies, hypersensitivity reactions, hepatitis B reactivation, neurologic reactions, hematological reactions, heart failure, autoimmunity.

Postmarketing Liver failure, hepatitis, autoimmune hepatitis, sarcoidosis, Merkel cell carcinoma, demyelinating disorders, cerebrovascular accident, interstitial lung disease, pulmonary embolism, Stevens Johnson Syndrome, cutaneous vasculitis, erythema multiforme, systemic vasculitis, deep vein thrombosis.

Pharmacology

Tocilizumab is a humanized IgG1 kappa monoclonal antibody that binds to soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated signaling involved in inflammatory and immune processes.

TNF-alpha blocker; adalimumab-bwwd is a recombinant human IgG1 monoclonal antibody that binds specifically to TNF-alpha and blocks its interaction with the p55 and p75 cell surface TNF receptors, also lysing surface TNF-expressing cells in vitro in the presence of complement.

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Most Common Insurance

Anthem BCBS

Actemra