| Rheumatoid Arthritis

Rituxan vs Inflectra

Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.

Deep comparison between: Rituxan vs Inflectra with Prescriber.AI

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Safety signalsInflectra has a higher rate of injection site reactions vs Rituxan based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Inflectra but not Rituxan, including UnitedHealthcare

Category

Rituxan

Inflectra

At A Glance

RouteIV infusion

ClassAnti-CD20 monoclonal antibody

RouteIV infusion

FrequencyEvery 6-8 weeks

ClassTNF-alpha antagonist

Indications

Lymphoma, Non-Hodgkin
Chronic Lymphocytic Leukemia
Rheumatoid Arthritis
Granulomatosis with polyangiitis
Microscopic Polyarteritis
Pemphigus Vulgaris
Acute lymphocytic leukemia

Ulcerative Colitis
Rheumatoid Arthritis
Ankylosing spondylitis
Arthritis, Psoriatic
Psoriasis vulgaris

Dosing

Lymphoma, Non-Hodgkin 375 mg/m2 IV; weekly for 4 or 8 doses for relapsed/refractory low-grade or follicular NHL; Day 1 of each chemotherapy cycle for up to 8 doses for previously untreated follicular or DLBCL; every 8 weeks for 12 doses as single-agent maintenance.

Acute lymphocytic leukemia 375 mg/m2 IV for 6 total infusions in combination with LMB chemotherapy (two doses during each of the two induction courses, one dose during each of the two consolidation courses) for pediatric patients aged 6 months and older.

Chronic Lymphocytic Leukemia 375 mg/m2 IV the day prior to initiation of cycle 1 FC chemotherapy, then 500 mg/m2 on Day 1 of cycles 2-6 every 28 days.

Rheumatoid Arthritis Two 1,000 mg IV infusions separated by 2 weeks per course in combination with methotrexate; subsequent courses every 24 weeks (no sooner than 16 weeks); premedicate with methylprednisolone 100 mg IV 30 minutes prior to each infusion.

Granulomatosis with polyangiitis, Microscopic Polyarteritis Induction: 375 mg/m2 IV once weekly for 4 weeks with glucocorticoids; follow-up: two 500 mg IV infusions separated by 2 weeks, then 500 mg IV every 6 months based on clinical evaluation.

Pemphigus Vulgaris Two 1,000 mg IV infusions separated by 2 weeks in combination with a tapering course of glucocorticoids; then 500 mg IV at Month 12 and every 6 months thereafter or based on clinical evaluation.

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

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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)

Drug Interactions

537View drug interactions

1225View drug interactions

Adverse Reactions

Most common (>=25%) Infusion-related reactions, fever, lymphopenia, chills, infection, asthenia (in NHL); infusion-related reactions, neutropenia (in CLL)

Serious Fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B reactivation with fulminant hepatitis, progressive multifocal leukoencephalopathy, tumor lysis syndrome, sepsis, cardiovascular events, renal toxicity, bowel obstruction and perforation

Postmarketing Prolonged pancytopenia, fatal cardiac failure, progressive multifocal leukoencephalopathy, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease, posterior reversible encephalopathy syndrome

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

Rituximab is a chimeric murine/human IgG1 kappa monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).

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.

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Most Common Insurance

Anthem BCBS

Rituxan