Comparative Pharmacology
Head-to-head clinical analysis: ACTH versus ACTHAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTH versus ACTHAR.
ACTH vs ACTHAR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACTH (corticotropin) stimulates the adrenal cortex to release cortisol, corticosterone, aldosterone, and androgenic steroids. It binds to the melanocortin 2 receptor (MC2R) in the adrenal gland, activating adenylyl cyclase and increasing intracellular cAMP.
ACTHAR (repository corticotropin injection) is a purified adrenocorticotropic hormone (ACTH) analogue that stimulates the adrenal cortex to release cortisol, corticosterone, and aldosterone. It also has glucocorticoid and mineralocorticoid effects, and is thought to exert anti-inflammatory and immunosuppressive effects through melanocortin receptor activation, independent of adrenal steroid production.
40-80 units intramuscularly or subcutaneously every 24-72 hours for chronic conditions; 25 units intravenously over 8 hours for diagnostic use.
ACTHAR (repository corticotropin injection) 80 U/mL; for acute exacerbation of multiple sclerosis: 80-120 U IM daily for 2-3 weeks. For infantile spasms: 150 U/m² IM daily divided twice daily for 2 weeks, then taper.
None Documented
None Documented
15 minutes (intravenous); rapid clearance due to enzymatic degradation; clinical effect persists 2-4 hours due to steroidogenesis
15-20 minutes (intravenous); clinical duration longer due to sustained adrenal stimulation.
Renal: <5% unchanged; hepatic metabolism via proteolysis; <1% biliary/fecal
Primarily renal; <5% unchanged in urine; extensive metabolism via proteolysis.
Category C
Category C
Corticotropin
Corticotropin