| Rheumatoid Arthritis
Enbrel vs Otrexup
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Enbrel vs Otrexup 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 signalsOtrexup has a higher rate of injection site reactions vs Enbrel based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Otrexup but not Enbrel, including UnitedHealthcare
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Category
Enbrel
Otrexup
At A Glance
SC injection
Once weekly
TNF-alpha inhibitor
SC injection
Once weekly
Folate analog metabolic inhibitor
Indications
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Ankylosing spondylitis
- Psoriasis vulgaris
- Polyarticular Juvenile Idiopathic Arthritis, Rheumatoid Factor Negative
- Juvenile psoriatic arthritis
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
Dosing
Rheumatoid Arthritis, Arthritis, Psoriatic, Ankylosing spondylitis 50 mg SC once weekly, with or without MTX
Psoriasis vulgaris 50 mg SC twice weekly for 3 months (loading), then 50 mg SC once weekly (maintenance)
Polyarticular Juvenile Idiopathic Arthritis, Rheumatoid Factor Negative, Juvenile psoriatic arthritis 0.8 mg/kg SC once weekly, maximum 50 mg per week
Rheumatoid Arthritis 7.5 mg SC once weekly; adjust dose gradually; doses greater than 20 mg/week associated with significant increase in serious toxic reactions in adults.
Juvenile polyarthritis 10 mg/m2 SC once weekly; adjust dose gradually.
Psoriasis 10 to 25 mg SC once weekly; do not exceed 30 mg/week; reduce to lowest effective dose once optimal response is achieved.
Contraindications
- Sepsis
- Pregnancy
- Alcoholism, alcoholic liver disease, or other chronic liver disease
- Overt or laboratory evidence of immunodeficiency syndromes
- Preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia
- Known hypersensitivity to methotrexate
Adverse Reactions
Most common Infections (upper respiratory tract infection, sinusitis, influenza), injection site reactions (erythema, itching, pain, swelling)
Serious Serious infections (pneumonia, cellulitis, septic arthritis, sepsis), neurologic events, congestive heart failure, hematologic events
Postmarketing Pancytopenia, anemia, leukopenia, neutropenia, thrombocytopenia, aplastic anemia, congestive heart failure, inflammatory bowel disease, angioedema, autoimmune hepatitis, macrophage activation syndrome, systemic vasculitis, sarcoidosis, lupus-like syndrome, melanoma, non-melanoma skin cancers, Merkel cell carcinoma, convulsions, multiple sclerosis, demyelination, optic neuritis, transverse myelitis, uveitis, scleritis, glomerulonephritis, interstitial lung disease, Stevens-Johnson syndrome, toxic epidermal necrolysis, opportunistic infections
Most common (>=10%) Elevated liver function tests, nausea/vomiting, ulcerative stomatitis, leukopenia, abdominal distress
Serious Bone marrow suppression, hepatotoxicity, interstitial pneumonitis, opportunistic infections, embryo-fetal toxicity, renal failure, pulmonary fibrosis
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, anaphylactoid reactions, reversible lymphoma, skin necrosis
Pharmacology
Etanercept is a dimeric soluble form of the human p75 TNF receptor that inhibits binding of TNF-alpha and TNF-beta (lymphotoxin alpha) to cell surface TNF receptors, rendering TNF biologically inactive and modulating downstream inflammatory responses including adhesion molecule expression, cytokine levels, and matrix metalloproteinase levels.
Methotrexate inhibits dihydrofolic acid reductase, preventing reduction of dihydrofolates to tetrahydrofolates and thereby interfering with DNA synthesis, repair, and cellular replication; in RA the mechanism is unknown but may affect immune function, and in psoriasis it exploits the markedly increased rate of epithelial cell proliferation.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Enbrel
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (11/12)
Otrexup
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Enbrel
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Enbrel
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Enbrel.
No savings programs available for Otrexup.
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EnbrelView full Enbrel profile
OtrexupView full Otrexup profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.