The FDA’s approval is based on results from two phase III studies, one of which found the injectable and IV forms of Actemra to be comparable in safety and effectiveness. The other study found that Actemra injections plus DMARDs better reduce the number of tender and swollen joints and better slow disease progression than an inactive injection (placebo) plus DMARDs.

Actemra pre-filled syringes are expected to be available starting in November 2013.

Methotrexate: Faster Shot, No More Filling Syringes

Methotrexate is already available in a self-injected form. What makes Otrexup different is that it comes in a single-dose, pre-filled auto-injector. Pre-filled means patients or their caretakers will no longer have to draw up a syringe and fill it from a multi-dose vial. A patient can easily give his or her self the shot.

“The auto-injector makes the process more convenient, and it would increase the confidence of older patients with poor hand dexterity,” Miller says. “It also provides a quicker shot. That should be less painful and scary for kids.” Methotrexate is the cornerstone of treatment for kids with JIA.

Studies have found that, for some patients with rheumatoid arthritis, methotrexate injections may be more effective than the form taken by mouth.

Otrexup is expected to be available in early 2014.

Convenience at a Higher Cost?

The pre-filled self-injected Actemra will cost slightly more than the IV form, according to the drug manufacturer. The monthly cost of Actemra IV is between $1,250 and $2,500 a month, depending on your dose. It will cost between $1,400 and $2,800 a month for the self-injected form of Actemra, depending if you take it once a week or every other week.

Miller says the cost for Otrexup syringes may be considerably higher than for methotrexate syringes that patients fill themselves.