| Juvenile polyarthritis
Actemra vs Xatmep
Side-by-side clinical, coverage, and cost comparison for juvenile polyarthritis.Deep comparison between: Actemra vs Xatmep 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 signalsXatmep has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xatmep but not Actemra, including UnitedHealthcare
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Category
Actemra
Xatmep
At A Glance
IV infusion or SC injection
Every 4 weeks (IV) or Every week to Every other week (SC)
IL-6 receptor antagonist
Oral
Once weekly
Folate analog metabolic inhibitor
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
- Acute lymphocytic leukemia
- Juvenile polyarthritis
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.
Acute lymphocytic leukemia 20 mg/m2 given one time weekly as part of a multi-agent combination chemotherapy maintenance regimen, oral.
Juvenile polyarthritis Starting dose of 10 mg/m2 given one time weekly, oral; titrate gradually to achieve optimal response, up to 30 mg/m2/week in pediatric patients.
Contraindications
- Known hypersensitivity to tocilizumab
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
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 Ulcerative stomatitis, leukopenia, nausea, abdominal distress, malaise, fatigue, chills, fever, dizziness, decreased resistance to infection
Serious Bone marrow suppression, serious infections, renal toxicity, gastrointestinal toxicity, hepatic toxicity, pulmonary toxicity, hypersensitivity and dermatologic reactions, secondary malignancies, infertility
Postmarketing Pancytopenia, aplastic anemia, thromboembolic events, hepatotoxicity, cirrhosis, fatal opportunistic infections (including Pneumocystis jiroveci pneumonia), leukoencephalopathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, pulmonary fibrosis
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.
Methotrexate inhibits dihydrofolic acid reductase, interfering with DNA synthesis, repair, and cellular replication by blocking reduction of dihydrofolates to tetrahydrofolates required for purine nucleotide and thymidylate synthesis; the mechanism in pJIA is unknown but may affect immune function.
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Most Common Insurance
Anthem BCBS
Actemra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Xatmep
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (2/12) · Qty limit (0/12)
UnitedHealthcare
Actemra
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Xatmep
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Actemra
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Xatmep
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Actemra.
No savings programs available for Xatmep.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.