Comparative Pharmacology
Head-to-head clinical analysis: ACTHAR versus ACTHAR GEL AUTOINJECTOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTHAR versus ACTHAR GEL AUTOINJECTOR.
ACTHAR vs ACTHAR GEL (AUTOINJECTOR)
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
ACTHAR Gel (repository corticotropin injection) acts primarily by stimulating the adrenal cortex to secrete corticosteroids (cortisol, corticosterone, and aldosterone), which exert anti-inflammatory, immunosuppressive, and antiproliferative effects. The exact mechanism in specific indications (e.g., infantile spasms) is not fully understood but may involve modulation of the hypothalamic-pituitary-adrenal axis and direct effects on the central nervous system.
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.
Initial: 40-80 units intramuscularly or subcutaneously every 24-48 hours; maintenance: 20-40 units intramuscularly or subcutaneously every 48 hours. Titrate based on response.
None Documented
None Documented
15-20 minutes (intravenous); clinical duration longer due to sustained adrenal stimulation.
The terminal half-life of exogenously administered ACTH is approximately 15 minutes; however, the duration of adrenal cortisol stimulation persists for 6-12 hours after IM administration due to prolonged absorption from the gel formulation.
Primarily renal; <5% unchanged in urine; extensive metabolism via proteolysis.
ACTH (corticotropin) is metabolized by tissue peptidases; renal excretion accounts for <5% of unchanged drug. Biliary/fecal elimination is negligible.
Category C
Category C
Corticotropin
Corticotropin