| Rheumatoid Arthritis
Acthar vs Amjevita
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Acthar vs Amjevita 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 signalsAmjevita has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Amjevita but not Acthar, including UnitedHealthcare
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Category
Acthar
Amjevita
At A Glance
IM or SC injection
Corticotropin analog
SC injection
Every other week
TNF-alpha antagonist
Indications
- Infantile Spasm
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Lupus Erythematosus, Systemic
- Dermatomyositis
- Polymyositis
- Erythema Multiforme
- Stevens-Johnson Syndrome
- Serum Sickness
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis, Posterior
- Choroiditis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Rheumatoid Arthritis
- Juvenile arthritis
- Arthritis, Psoriatic
- Ankylosing spondylitis
- Crohn Disease
- Ulcerative Colitis
- Psoriasis vulgaris
- Hidradenitis Suppurativa
- Uveitis
Dosing
Infantile Spasm 150 U/m2/day IM divided into 75 U/m2 twice daily for 2 weeks, then taper over 2 weeks; Acthar Gel vial only -- do not use the pre-filled SelfJect injector.
Multiple Sclerosis 80-120 units IM or SC daily for 2-3 weeks for acute exacerbations; taper as needed.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Lupus Erythematosus, Systemic, Dermatomyositis, Polymyositis, Erythema Multiforme, Stevens-Johnson Syndrome, Serum Sickness, Keratitis, Iritis, Iridocyclitis, Uveitis, Posterior, Choroiditis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome 40-80 units IM or SC every 24-72 hours; individualize dosing based on disease severity and patient response; taper dose upon discontinuation.
Rheumatoid Arthritis, Arthritis, Psoriatic, Ankylosing spondylitis Adults: 40 mg SC every other week; some RA patients not receiving MTX may benefit from 40 mg every week or 80 mg every other week.
Juvenile arthritis, Uveitis (pediatric, >=2 years) Weight-based SC every other week: 10 mg (10 to <15 kg), 20 mg (15 to <30 kg), 40 mg (>=30 kg).
Crohn Disease (adults) 160 mg SC on Day 1, 80 mg on Day 15, then 40 mg every other week starting Day 29.
Crohn Disease (pediatric, >=6 years) Weight-based: 80 mg Day 1 / 40 mg Day 15 / 20 mg every other week (17 to <40 kg); 160 mg Day 1 / 80 mg Day 15 / 40 mg every other week (>=40 kg).
Ulcerative Colitis Adults: 160 mg SC on Day 1, 80 mg on Day 15, then 40 mg every other week starting Day 29; discontinue if no clinical remission by Day 57.
Psoriasis vulgaris, Uveitis (adults) 80 mg SC initial dose, then 40 mg every other week starting one week after the initial dose.
Hidradenitis Suppurativa (adults) 160 mg SC on Day 1, 80 mg on Day 15, then 40 mg every week or 80 mg every other week starting Day 29.
Hidradenitis Suppurativa (adolescents >=12 years, >=30 kg) Weight-based: 80 mg Day 1 / 40 mg every other week from Day 8 (30 to <60 kg); 160 mg Day 1 / 80 mg Day 15 / 40 mg weekly or 80 mg every other week from Day 29 (>=60 kg).
Contraindications
- Intravenous administration
- Use in infants under 2 years of age with suspected congenital infections
- Concomitant live or live-attenuated vaccines during immunosuppressive doses of Acthar Gel
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of peptic ulcer
- Congestive heart failure
- Uncontrolled hypertension
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
- Sensitivity to proteins of porcine origin
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Adverse Reactions
Most common (>=5%) Infections, convulsions, hypertension, irritability, pyrexia (reported in infantile spasm trials at recommended dose)
Serious Cushing's syndrome, adrenal insufficiency upon withdrawal, elevated blood pressure, salt and water retention, hypokalemia, gastrointestinal perforation and bleeding, behavioral and mood disturbances, ophthalmic effects, decreased bone density, negative effects on growth and physical development
Postmarketing Anaphylaxis, necrotizing angitis, pancreatitis, intracranial hemorrhage, subdural hematoma, reversible brain shrinkage, vertebral compression fractures, insomnia, injection site reactions
Most common (>=5%) Injection site reactions, upper respiratory infection, sinusitis, headache, rash, nausea, urinary tract infection, flu syndrome, abdominal pain, back pain, hypertension.
Serious Serious infections (pneumonia, septic arthritis, erysipelas, cellulitis, diverticulitis, pyelonephritis), tuberculosis, opportunistic infections, malignancies, hypersensitivity reactions, hepatitis B virus reactivation, neurologic reactions, hematological reactions, heart failure, autoimmunity.
Postmarketing Diverticulitis, large bowel perforations, pancreatitis, pyrexia, liver failure, autoimmune hepatitis, sarcoidosis, Merkel Cell Carcinoma, demyelinating disorders, cerebrovascular accident, interstitial lung disease, pulmonary embolism, Stevens Johnson Syndrome, cutaneous vasculitis, erythema multiforme, new or worsening psoriasis, alopecia, systemic vasculitis, deep vein thrombosis.
Pharmacology
Repository corticotropin (ACTH) analog that stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and weak androgens; also reported to bind melanocortin receptors, with the trophic effects on the adrenal cortex appearing to be mediated by cyclic AMP.
Adalimumab-atto is a recombinant human IgG1 monoclonal antibody that binds specifically to TNF-alpha and blocks its interaction with the p55 and p75 cell surface TNF receptors, inhibiting TNF-mediated inflammatory and immune responses; it also lyses surface TNF-expressing cells in vitro in the presence of complement and modulates downstream biological responses including adhesion molecule expression (ELAM-1, VCAM-1, ICAM-1).
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Acthar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
Amjevita
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Amjevita
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Amjevita
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
No savings programs available for Amjevita.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.