Acthar Gel (Repository Corticotropin Injection) for Psoriatic Arthritis

Acthar Gel (repository corticotropin injection) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for short-term use with other treatment during a flare of psoriatic arthritis in adults.

How Acthar Gel Works and How It’s Taken

Acthar Gel is made from a complex mixture of adrenocorticotropic hormone (ACTH)-like substances and other pituitary peptides. It stimulates the adrenal glands to release natural steroid hormones, including cortisol. The exact way it works is not fully known, but in psoriatic arthritis, it may help reduce inflammation and calm an overactive immune response.

Doctors prescribe Acthar Gel with other treatments for psoriatic arthritis for short-term use during a flare.

Acthar Gel is given as an injection under the skin or into a muscle. The prefilled SelfJect injector is for under-the-skin use by adults only. People and caregivers should receive training and follow the instructions provided by their healthcare professional.

Typical Dosing for Psoriatic Arthritis

For conditions such as psoriatic arthritis, the usual dose is 40 to 80 units injected under the skin or into a muscle every 24 to 72 hours. The dose and schedule must be adjusted for each person.

Treatment should not be stopped suddenly after prolonged use. A healthcare professional may slowly lower the dose and increase the time between injections.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Acthar Gel Side Effects

The prescribing information does not report common side effects specifically for adults with psoriatic arthritis. Commonly reported side effects of Acthar Gel include:

Injection-site reactions
Asthenic conditions (fatigue, weakness, or lack of energy)
Fluid retention, including peripheral swelling
Insomnia
Headache
Increased blood glucose

The most common side effects reported in studies of infantile spasms may also occur in adults treated for other purposes, although their frequency may differ by dose and regimen:

Increased risk of infections
Hypertension (high blood pressure)
Irritability
Fever
Convulsions (seizures)

Serious Side Effects and Warnings

Acthar Gel can cause serious side effects that may require immediate medical attention. These include:

Serious infections — Acthar Gel can raise the risk of viral, bacterial, fungal, protozoan, or parasitic infections.
Cushing’s syndrome and adrenal suppression — Steroidlike effects can occur during treatment, and adrenal insufficiency after stopping can cause severe weakness or low blood pressure.
High blood pressure, fluid retention, and hypokalemia (low potassium levels) — These effects can cause swelling, worsening blood pressure, or heart-related symptoms.
Gastrointestinal bleeding, ulcers, or perforation — These problems can cause stomach pain, black stools, or vomiting blood.
Severe mood or behavior changes — Insomnia, mood swings, severe depression, or psychosis can occur.
Eye problems — Longer use can cause cataracts, glaucoma, or eye infections that affect vision.
Severe allergic reactions — Anaphylaxis can cause trouble breathing, hives, swelling, or low blood pressure.
Heart problems — Congestive heart failure and abnormal heart rhythms can occur.
Pancreatitis — Inflammation of the pancreas can cause severe abdominal pain, nausea, or vomiting.
Bone loss and osteoporosis — Weakened bones can raise the risk of fractures.

Get medical help right away if you think you are having a serious reaction.

How To Save on Acthar Gel

Eligible people with commercial or private insurance may have a copay as low as $0, with up to $15,000 in support per calendar year, through the Acthar Gel Commercial Co-Pay Program.

The Acthar Gel website also provides information about Medicare savings options and the Acthar Patient Assistance Program for eligible people who are uninsured, underinsured, or have lost insurance.

Acthar Patient Support can connect you with a Case Manager and Nurse Navigator to help with insurance approval, provide injection training, and offer ongoing support. To learn more, visit Acthar Gel financial assistance or call 888-435-2284.

What To Know Before Taking Acthar Gel

Do not receive live or live-attenuated vaccines while taking immunosuppressive doses of Acthar Gel.

Tell your doctor if you are allergic to repository corticotropin injection or any ingredients in Acthar Gel. Also tell your doctor if you are sensitive to proteins from pigs, because people with this sensitivity should not use Acthar Gel.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention diuretics, sometimes called water pills. Acthar Gel may increase the electrolyte loss caused by these medicines.

Also tell your doctor if you have an infection, tuberculosis, or a past positive tuberculosis test.

Do not use Acthar Gel if you have:

Scleroderma
Osteoporosis
A fungal infection affecting the whole body
Herpes simplex infection of the eye
Recent surgery
A current or past peptic ulcer
Congestive heart failure
Uncontrolled high blood pressure
Primary adrenal insufficiency
Adrenal overactivity
Sensitivity to proteins from pigs

Acthar Gel is also FDA-approved for:

Infantile spasms in infants and children under age 2
Acute exacerbations of multiple sclerosis in adults
Adjunctive, short-term therapy during an acute episode or exacerbation of rheumatoid arthritis, juvenile rheumatoid arthritis in selected cases, or ankylosing spondylitis
An exacerbation of systemic lupus erythematosus or systemic dermatomyositis (polymyositis), or maintenance therapy in selected cases
Severe erythema multiforme
Stevens-Johnson syndrome
Serum sickness
Severe acute and chronic allergic and inflammatory eye conditions, including keratitis, iritis, iridocyclitis, diffuse posterior uveitis and choroiditis, optic neuritis, chorioretinitis, and anterior segment inflammation
Symptomatic sarcoidosis
Nephrotic syndrome without uremia of the idiopathic type or caused by lupus erythematosus, to induce diuresis or remission of proteinuria

If you are pregnant, planning to become pregnant, or breastfeeding while taking Acthar Gel, talk with your doctor about the risks and benefits.

Acthar Gel may cause fetal harm when administered during pregnancy. Babies born after exposure to Acthar Gel during pregnancy should be watched for signs of low adrenal function.

There are no data showing whether corticotropin passes into breast milk, affects a breastfed baby, or affects milk production.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Acthar Gel for psoriatic arthritis?

There are no clinical study results for Acthar Gel in psoriatic arthritis. The prescribing information does not provide response rates, numbers on symptom improvement, or a specific timeline for when symptoms may begin to improve.

Acthar Gel is listed as a short-term add-on treatment during an acute episode or flare of psoriatic arthritis. Ask your healthcare provider what results to expect and how long treatment may take.

Should I take Acthar Gel for psoriatic arthritis if I have an infection?

Tell your doctor if you have an infection before taking Acthar Gel. Acthar Gel may increase the risk of infection, make an existing infection worse, or hide some signs of infection.

Do not take Acthar Gel if you have a systemic fungal infection, which affects the body. Contact your doctor if you develop an infection or fever during treatment, and try to avoid close contact with people who have infections.

What tests or monitoring are needed with Acthar Gel for psoriatic arthritis?

Your doctor may monitor you for infections, Cushing’s syndrome, high blood pressure, fluid retention, and changes in sodium and potassium levels. After long-term treatment is stopped, you may also be monitored for adrenal insufficiency, which means the adrenal glands are not making enough hormones.

Acthar Gel can hide signs of other health problems, so careful monitoring is important. Your healthcare provider may also monitor your bone density and check for cataracts, glaucoma, or eye infections during long-term treatment.