| Rheumatoid Arthritis
Rinvoq vs Otrexup
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Rinvoq 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 Rinvoq based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Otrexup but not Rinvoq, including UnitedHealthcare
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Category
Rinvoq
Otrexup
At A Glance
Oral
Once daily or twice daily (pediatric oral solution)
JAK inhibitor
SC injection
Once weekly
Folate analog metabolic inhibitor
Indications
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Dermatitis, Atopic
- Ulcerative Colitis
- Crohn Disease
- Ankylosing spondylitis
- Non-Radiographic Axial Spondyloarthritis
- Juvenile polyarthritis
- Giant Cell Arteritis
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
Dosing
Rheumatoid Arthritis 15 mg orally once daily
Arthritis, Psoriatic - Adults 15 mg orally once daily
Arthritis, Psoriatic - Pediatric 2 to <18 years Dosing based on weight: 10-<20 kg: 3 mg oral solution twice daily; 20-<30 kg: 4 mg oral solution twice daily; >=30 kg: 6 mg oral solution twice daily or 15 mg tablet once daily
Dermatitis, Atopic - Adults <65 years 15 mg orally once daily; may increase to 30 mg once daily if inadequate response
Dermatitis, Atopic - Adults >=65 years 15 mg orally once daily
Ulcerative Colitis - Induction 45 mg orally once daily for 8 weeks
Ulcerative Colitis - Maintenance 15 mg orally once daily; may use 30 mg once daily for refractory, severe, or extensive disease
Crohn Disease - Induction 45 mg orally once daily for 12 weeks
Crohn Disease - Maintenance 15 mg orally once daily; may use 30 mg once daily for refractory, severe, or extensive disease
Ankylosing spondylitis 15 mg orally once daily
Non-Radiographic Axial Spondyloarthritis 15 mg orally once daily
Juvenile polyarthritis Dosing based on weight: 10-<20 kg: 3 mg oral solution twice daily; 20-<30 kg: 4 mg oral solution twice daily; >=30 kg: 6 mg oral solution twice daily or 15 mg tablet once daily
Giant Cell Arteritis 15 mg orally once daily in combination with tapering corticosteroids; may continue as monotherapy after corticosteroid discontinuation
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
- Known hypersensitivity to upadacitinib or any excipients
- 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 (>=3%) - Rheumatoid Arthritis Upper respiratory tract infection, nausea, cough, pyrexia
Most common (>=3%) - Atopic Dermatitis Upper respiratory tract infection, acne, herpes simplex, headache, increased blood creatine phosphokinase, cough, hypersensitivity, folliculitis, nausea, abdominal pain
Most common (>=3%) - Ulcerative Colitis Induction Upper respiratory tract infection, acne, increased blood creatine phosphokinase, neutropenia, rash, elevated liver enzymes, lymphopenia
Most common (>=3%) - Ulcerative Colitis Maintenance Upper respiratory tract infection, increased blood creatine phosphokinase, pyrexia, neutropenia, elevated liver enzymes, rash, herpes zoster, folliculitis, hypercholesterolemia, influenza, herpes simplex
Most common (>=3%) - Crohn Disease Induction Upper respiratory tract infection, anemia, acne, pyrexia, increased blood creatine phosphokinase, influenza, herpes simplex
Most common (>=3%) - Crohn Disease Maintenance Upper respiratory tract infection, pyrexia, herpes zoster, headache, acne, gastroenteritis, fatigue, increased blood creatine phosphokinase
Most common (>=5%) - Giant Cell Arteritis Upper respiratory tract infection, headache, fatigue, peripheral edema, cough, anemia, rash, herpes zoster, nausea
Serious Serious infections, opportunistic infections, tuberculosis, malignancies, major adverse cardiovascular events, thrombosis, gastrointestinal perforations, hypersensitivity reactions, eczema herpeticum
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
Upadacitinib is a JAK inhibitor that modulates intracellular signaling by preventing JAK-mediated phosphorylation and activation of STATs, thereby influencing immune cell function and hematopoiesis.
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
Rinvoq
- 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
Rinvoq
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Rinvoq
- 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
Cost estimate not availableCo-Pay Relief Rheumatoid Arthritis Fund
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
No savings programs available for Otrexup.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.