| Rheumatoid Arthritis

Actemra vs Inflectra

Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.

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

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

Category

Actemra

Inflectra

At A Glance

RouteIV infusion or SC injection

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

ClassIL-6 receptor antagonist

RouteIV infusion

FrequencyEvery 6-8 weeks

ClassTNF-alpha antagonist

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

Ulcerative Colitis
Rheumatoid Arthritis
Ankylosing spondylitis
Arthritis, Psoriatic
Psoriasis vulgaris

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.

Crohn's Disease, Ulcerative Colitis 5 mg/kg IV at 0, 2, and 6 weeks, then every 8 weeks; regimen applies to adult and pediatric patients >= 6 years.

Rheumatoid Arthritis 3 mg/kg IV at 0, 2, and 6 weeks, then every 8 weeks in combination with methotrexate; may increase up to 10 mg/kg every 8 weeks or as often as every 4 weeks for incomplete response.

Ankylosing spondylitis 5 mg/kg IV at 0, 2, and 6 weeks, then every 6 weeks.

Arthritis, Psoriatic, Psoriasis vulgaris 5 mg/kg IV at 0, 2, and 6 weeks, then every 8 weeks.

Contraindications

Known hypersensitivity to tocilizumab

Doses >5 mg/kg in patients with moderate or severe heart failure
Previous severe hypersensitivity reaction to infliximab products, inactive ingredients of INFLECTRA, or any murine proteins (including anaphylaxis, hypotension, and serum sickness)

Drug Interactions

856View drug interactions

1225View 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 (>10%) Infections (upper respiratory tract infection, sinusitis, pharyngitis), infusion-related reactions, headache, abdominal pain

Serious Serious infections (pneumonia, cellulitis, abscess, sepsis, tuberculosis, opportunistic infections), malignancies, lymphoma, hepatotoxicity (acute liver failure, autoimmune hepatitis), severe infusion reactions, lupus-like syndrome

Postmarketing Agranulocytosis, neutropenia, interstitial lung disease, Stevens-Johnson Syndrome, toxic epidermal necrolysis, peripheral demyelinating disorders (Guillain-Barre syndrome), acute liver failure, anaphylactic shock, cerebrovascular accidents, leukemia, melanoma, Merkel cell carcinoma

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.

Infliximab-dyyb is a chimeric IgG1kappa monoclonal antibody TNF-alpha antagonist that neutralizes the biological activity of TNFalpha by binding with high affinity to soluble and transmembrane forms of TNFalpha, inhibiting receptor binding and downstream proinflammatory cytokine activity in RA, CD, UC, AS, PsA, and Ps.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Actemra