| Rheumatoid Arthritis
Acthar vs Inflectra
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Acthar 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 Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Inflectra but not Acthar, including UnitedHealthcare
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Category
Acthar
Inflectra
At A Glance
IM or SC injection
Corticotropin analog
IV infusion
Every 6-8 weeks
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
- Ulcerative Colitis
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Arthritis, Psoriatic
- Psoriasis vulgaris
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.
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
- 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
- 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)
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 (>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
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.
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.
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)
Inflectra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Inflectra
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Inflectra
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
$0/fillfill
Inflectra Co-Pay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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ActharView full Acthar profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.