| Juvenile polyarthritis
Orencia vs Otrexup
Side-by-side clinical, coverage, and cost comparison for juvenile polyarthritis.Deep comparison between: Orencia vs Otrexup 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 signalsOtrexup has a higher rate of injection site reactions vs Orencia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Otrexup but not Orencia, including UnitedHealthcare
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Category
Orencia
Otrexup
At A Glance
SC injection, IV infusion
Weekly (SC) or every 4 weeks (IV)
Selective T-cell costimulation modulator
SC injection
Once weekly
Folate analog metabolic inhibitor
Indications
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Arthritis, Psoriatic
- Acute GVH disease
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
Dosing
Rheumatoid Arthritis IV: weight-based (500-1,000 mg) infused over 30 minutes at Weeks 0, 2, and 4, then every 4 weeks; SC: 125 mg once weekly, with optional IV loading dose on Day 1.
Juvenile polyarthritis IV (>=6 yrs): 10 mg/kg (body weight <75 kg) or adult weight-based dose (>=75 kg, max 1,000 mg) at Weeks 0, 2, and 4, then every 4 weeks; SC (>=2 yrs): 50 mg (10 to <25 kg), 87.5 mg (25 to <50 kg), or 125 mg (>=50 kg) once weekly without IV loading dose.
Arthritis, Psoriatic Adult IV: weight-based (500-1,000 mg) over 30 minutes at Weeks 0, 2, and 4, then every 4 weeks; Adult SC: 125 mg once weekly without IV loading dose; Pediatric SC (>=2 yrs): 50 mg (10 to <25 kg), 87.5 mg (25 to <50 kg), or 125 mg (>=50 kg) once weekly.
Acute GVH disease IV: patients >=6 yrs: 10 mg/kg (max 1,000 mg) over 60 minutes on Day -1, then Days 5, 14, and 28 post-transplant; patients 2 to <6 yrs: 15 mg/kg on Day -1, then 12 mg/kg on Days 5, 14, and 28.
Rheumatoid Arthritis 7.5 mg SC once weekly; adjust dose gradually; doses greater than 20 mg/week associated with significant increase in serious toxic reactions in adults.
Juvenile polyarthritis 10 mg/m2 SC once weekly; adjust dose gradually.
Psoriasis 10 to 25 mg SC once weekly; do not exceed 30 mg/week; reduce to lowest effective dose once optimal response is achieved.
Contraindications
—
- Pregnancy
- Alcoholism, alcoholic liver disease, or other chronic liver disease
- Overt or laboratory evidence of immunodeficiency syndromes
- Preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia
- Known hypersensitivity to methotrexate
Adverse Reactions
Most common (>=10%) Headache, nasopharyngitis, upper respiratory tract infection, nausea (RA); in aGVHD: anemia, hypertension, CMV reactivation/infection, pyrexia, pneumonia, epistaxis, CD4 lymphocytes decreased, hypermagnesemia, acute kidney injury.
Serious Serious infections (pneumonia, cellulitis, urinary tract infection, bronchitis, diverticulitis), malignancies (lung cancer, lymphoma), hypersensitivity reactions, acute infusion-related reactions, COPD exacerbation.
Postmarketing Vasculitis (cutaneous and leukocytoclastic), new or worsening psoriasis, non-melanoma skin cancers (basal cell and squamous cell carcinoma), angioedema, fatal anaphylaxis (IV), systemic injection reactions (SC).
Most common (>=10%) Elevated liver function tests, nausea/vomiting, ulcerative stomatitis, leukopenia, abdominal distress
Serious Bone marrow suppression, hepatotoxicity, interstitial pneumonitis, opportunistic infections, embryo-fetal toxicity, renal failure, pulmonary fibrosis
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, anaphylactoid reactions, reversible lymphoma, skin necrosis
Pharmacology
Abatacept is a selective T-cell costimulation modulator that inhibits T-lymphocyte activation by binding to CD80 and CD86, thereby blocking the CD28 costimulatory interaction required for full T-cell activation; activated T lymphocytes are implicated in the pathogenesis of RA, pJIA, and PsA.
Methotrexate inhibits dihydrofolic acid reductase, preventing reduction of dihydrofolates to tetrahydrofolates and thereby interfering with DNA synthesis, repair, and cellular replication; in RA the mechanism is unknown but may affect immune function, and in psoriasis it exploits the markedly increased rate of epithelial cell proliferation.
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Most Common Insurance
Anthem BCBS
Orencia
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Otrexup
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Orencia
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (5/8) · Qty limit (5/8)
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Orencia
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Orencia.
No savings programs available for Otrexup.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.