| Rheumatoid Arthritis

Actemra vs Ruxience

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

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

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

Category

Actemra

Ruxience

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

ClassCD20-directed cytolytic antibody

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

Lymphoma, Non-Hodgkin
Chronic Lymphocytic Leukemia
Rheumatoid Arthritis
Granulomatosis with polyangiitis
Microscopic Polyarteritis
Pemphigus 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.

Lymphoma, Non-Hodgkin 375 mg/m2 IV; once weekly for 4 or 8 doses (relapsed/refractory), on Day 1 of each chemotherapy cycle for up to 8 doses (previously untreated follicular or DLBCL), or every 8 weeks for 12 doses as single-agent maintenance.

Chronic Lymphocytic Leukemia 375 mg/m2 IV on Day 1 of Cycle 1, then 500 mg/m2 IV on Day 1 of Cycles 2-6 in combination with fludarabine and cyclophosphamide, every 28 days.

Rheumatoid Arthritis Two 1,000 mg IV infusions separated by 2 weeks (one course) every 24 weeks or based on clinical evaluation, but not sooner than every 16 weeks, in combination with methotrexate.

Granulomatosis with polyangiitis, Microscopic Polyarteritis Induction: 375 mg/m2 IV once weekly for 4 weeks; follow-up: two 500 mg IV infusions separated by 2 weeks, then 500 mg IV every 6 months based on clinical evaluation, in combination with glucocorticoids.

Pemphigus Vulgaris Two 1,000 mg IV infusions separated by 2 weeks plus tapering glucocorticoids; maintenance: 500 mg IV at Month 12 and every 6 months thereafter; relapse: 1,000 mg IV, no sooner than 16 weeks after the previous infusion.

Contraindications

Known hypersensitivity to tocilizumab

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Drug Interactions

856View drug interactions

537View 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 (>=25%) Infusion-related reactions, fever, lymphopenia, chills, infection, asthenia (NHL); infusion-related reactions, neutropenia (CLL).

Serious Infusion-related reactions, severe mucocutaneous reactions, hepatitis B reactivation with fulminant hepatitis, progressive multifocal leukoencephalopathy, tumor lysis syndrome, infections, cardiovascular adverse reactions, renal toxicity, bowel obstruction and perforation.

Postmarketing Prolonged pancytopenia, marrow hypoplasia, late-onset neutropenia, fatal cardiac failure, uveitis, optic neuritis, systemic vasculitis, pleuritis, lupus-like syndrome, serum sickness, polyarticular arthritis, vasculitis with rash, viral infections including PML, Kaposi's sarcoma progression, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease, PRES/RPLS.

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.

Rituximab-pvvr is a chimeric monoclonal antibody that targets the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis through complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Actemra