| Juvenile polyarthritis
Otrexup vs Xatmep
Side-by-side clinical, coverage, and cost comparison for juvenile polyarthritis.Deep comparison between: Otrexup 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 Otrexup based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xatmep but not Otrexup, including UnitedHealthcare
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Category
Otrexup
Xatmep
At A Glance
SC injection
Once weekly
Folate analog metabolic inhibitor
Oral
Once weekly
Folate analog metabolic inhibitor
Indications
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
- Acute lymphocytic leukemia
- Juvenile polyarthritis
Dosing
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.
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
- 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
- Pregnancy in patients with non-malignant diseases
- Severe hypersensitivity to methotrexate
Adverse Reactions
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
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
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.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Otrexup
- 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
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xatmep
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · 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 Otrexup.
No savings programs available for Xatmep.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.