| Rheumatoid Arthritis
Otrexup vs Ruxience
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Otrexup 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 Otrexup based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ruxience but not Otrexup, including UnitedHealthcare
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Category
Otrexup
Ruxience
At A Glance
SC injection
Once weekly
Folate analog metabolic inhibitor
IV infusion
CD20-directed cytolytic antibody
Indications
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
- Lymphoma, Non-Hodgkin
- Chronic Lymphocytic Leukemia
- Rheumatoid Arthritis
- Granulomatosis with polyangiitis
- Microscopic Polyarteritis
- Pemphigus Vulgaris
Dosing
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.
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
- 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
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Adverse Reactions
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
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
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.
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).
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Most Common Insurance
Anthem BCBS
Otrexup
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Ruxience
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (0/12)
UnitedHealthcare
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Ruxience
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Ruxience
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Otrexup.
$0/fillfill
Ruxience Co-Pay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.