| Juvenile polyarthritis

Cimzia vs Actemra

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

Deep comparison between: Cimzia vs Actemra with Prescriber.AI

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

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

Category

Cimzia

Actemra

At A Glance

RouteSC injection

FrequencyEvery 2-4 weeks

ClassTNF-alpha inhibitor

RouteIV infusion or SC injection

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

ClassIL-6 receptor antagonist

Indications

Crohn Disease
Rheumatoid Arthritis
Juvenile polyarthritis
Arthritis, Psoriatic
Ankylosing spondylitis
Non-Radiographic Axial Spondyloarthritis
Psoriasis vulgaris

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

Dosing

Crohn Disease 400 mg SC (two 200 mg injections) at Weeks 0, 2, and 4; maintenance 400 mg every 4 weeks.

Rheumatoid Arthritis 400 mg SC at Weeks 0, 2, and 4; then 200 mg every 2 weeks; alternatively, 400 mg every 4 weeks may be considered for maintenance.

Juvenile polyarthritis Weight-based SC dosing at Weeks 0, 2, and 4, then maintenance every 2 weeks: 100 mg loading / 50 mg maintenance (10 to <20 kg); 200 mg loading / 100 mg maintenance (20 to <40 kg); 400 mg loading / 200 mg maintenance (>=40 kg).

Arthritis, Psoriatic 400 mg SC at Weeks 0, 2, and 4; then 200 mg every 2 weeks; alternatively, 400 mg every 4 weeks may be considered for maintenance.

Ankylosing spondylitis, Non-Radiographic Axial Spondyloarthritis 400 mg SC at Weeks 0, 2, and 4; then 200 mg every 2 weeks or 400 mg every 4 weeks.

Psoriasis vulgaris 400 mg SC every 2 weeks; for patients <=90 kg, 400 mg at Weeks 0, 2, and 4 followed by 200 mg every 2 weeks may be considered.

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.

Contraindications

History of hypersensitivity reaction to certolizumab pegol or any excipient (including angioedema, anaphylaxis, serum sickness, or urticaria)

Known hypersensitivity to tocilizumab

Drug Interactions

1384View drug interactions

856View drug interactions

Adverse Reactions

Most common (>=8%) Upper respiratory infections (18%), rash (9%), urinary tract infections (8%)

Serious Serious infections, malignancies, heart failure, hypersensitivity reactions, hepatitis B virus reactivation, neurologic reactions, hematologic reactions, autoimmunity, immunosuppression

Postmarketing Systemic vasculitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, new or worsening psoriasis (all subtypes), lichenoid skin reaction, sarcoidosis, melanoma, Merkel cell carcinoma

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.

Pharmacology

Certolizumab pegol is a PEGylated Fab' fragment of a humanized anti-TNF-alpha antibody that selectively neutralizes soluble and membrane-associated human TNF-alpha, a key pro-inflammatory cytokine; it lacks an Fc region and therefore does not fix complement or cause antibody-dependent cell-mediated cytotoxicity in vitro.

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.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Cimzia