| Rheumatoid Arthritis
Acthar vs Kineret
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Acthar vs Kineret 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 signalsKineret has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kineret but not Acthar, including UnitedHealthcare
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Category
Acthar
Kineret
At A Glance
IM or SC injection
Corticotropin analog
SC injection
Daily
IL-1 receptor 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
- Chronic Infantile Neurological, Cutaneous, and Articular Syndrome
- INTERLEUKIN 1 RECEPTOR ANTAGONIST DEFICIENCY
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 100 mg/day SC; administer every other day in severe renal insufficiency or ESRD (creatinine clearance <30 mL/min).
Chronic Infantile Neurological, Cutaneous, and Articular Syndrome Starting dose 1-2 mg/kg/day SC; titrate in 0.5 to 1 mg/kg increments to a maximum of 8 mg/kg/day; once daily or split into twice daily; administer every other day in severe renal insufficiency or ESRD.
INTERLEUKIN 1 RECEPTOR ANTAGONIST DEFICIENCY Starting dose 1-2 mg/kg/day SC; titrate in 0.5 to 1 mg/kg increments to a maximum of 8 mg/kg/day; administer every other day in severe renal insufficiency or ESRD.
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
- Known hypersensitivity to E. coli-derived proteins, anakinra, or any components of the product
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 reaction, worsening of RA, upper respiratory tract infections, headache, nausea, diarrhea, sinusitis, arthralgia, flu-like symptoms, abdominal pain
Serious Serious infections (cellulitis, pneumonia, bone and joint infections), neutropenia (particularly in combination with TNF blocking agents), lymphoma, other malignancies
Postmarketing Transaminase elevations, non-infectious hepatitis, thrombocytopenia (including severe), DRESS, injection site amyloid deposits
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.
IL-1 receptor antagonist; anakinra is a recombinant human IL-1Ra that competitively inhibits IL-1alpha and IL-1beta binding to the interleukin-1 type I receptor (IL-1RI), blocking downstream inflammatory and immunological responses including cartilage degradation and bone resorption.
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)
Kineret
- 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)
Kineret
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (1/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Kineret
- 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.
Cost estimate not availableAssistance Fund: Rheumatoid Arthritis
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.