Orencia vs. Rinvoq for Rheumatoid Arthritis and Psoriatic Arthritis: Important Differences and Potential Risks.

Key takeaways

Abatacept (Orencia) and upadacitinib (Rinvoq) are both medications used to treat rheumatoid arthritis (RA) and psoriatic arthritis (PsA). However, they belong to different medication classes and have distinct characteristics. Abatacept is a biologic disease-modifying anti-rheumatic drug (DMARD) that is administered via injection or infusion, while upadacitinib is a Janus kinase (JAK) inhibitor taken orally. Abatacept is also used for juvenile idiopathic arthritis and prevention of graft-versus-host disease, whereas upadacitinib is used for a broader range of conditions, including ulcerative colitis, Crohn's disease, and eczema. Abatacept is typically dosed based on body weight and given weekly or monthly, while upadacitinib is usually taken once daily. Common side effects of abatacept include headache and dizziness, while upadacitinib may cause acne and nausea. Both medications increase the risk of infections, but upadacitinib also carries risks of blood clots and potential harm during pregnancy. There is no generic version available for either medication.

Orencia

(abatacept)

Get free coupons

Rinvoq

(upadacitinib)

Get free coupons

Summary for Orencia

Prescription only

Orencia (abatacept) is an injectable biologic medication used for different types of autoimmune arthritis (joint inflammation), including rheumatoid arthritis (RA) and psoriatic arthritis (PsA). It's given as an injection under the skin once a week or as an infusion through the veins (IV) in the clinic once a month. Common side effects include infection, headache, and dizziness.

Indications for Orencia

Moderate-to-severe rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults
Moderate-to-severe polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
Prevention of short-term graft versus host disease (GVHD) in combination with a calcineurin inhibitor and methotrexate in adults and children ages 2 years and older

Pros and Cons for Orencia

Pros

Can be used in children age 2 years and older (for certain conditions)
Comes as a prefilled syringe or autoinjector for easy at-home injections
Clinic infusions are available for people who don't like to give themselves injections and are generally given only once a month
SQ injections are given once weekly and IV infusions are given once monthly

Cons

Raises your risk for infections because it weakens your immune system
Can't be used with other biologic medications because higher risk of infection
Can take 3 to 6 months to notice an improvement in your symptoms (for arthritis)
Only treats the symptoms and isn't a cure for inflammatory problems

Common Side Effects for Orencia

Headache (18%)
Sore throat, runny nose, or other cold-like symptoms (12%)
Dizziness (9%)
Cough (8%)
Back pain (7%)
High blood pressure (7%)
Upset stomach (6%)
Pain while urinating and other symptoms of an urinary tract infection (6%)

Please note: The side effects above were reported by adults who received Orencia (abatacept) for rheumatoid arthritis. The side effects you experience might be different if you're taking Orencia (abatacept) for a different condition or if you're injecting it under the skin.

Warnings for Orencia

Risk of serious infections
Severe allergic reactions
Vaccines
Worsening breathing problems
Falsely high blood sugars

Summary for Rinvoq

Prescription only

Rinvoq (upadacitinib) is a Janus kinase (JAK) inhibitor. It treats many inflammatory conditions. This includes rheumatoid arthritis (RA), ulcerative colitis (UC), Crohn's disease (CD), and eczema (atopic dermatitis). It's often used when other treatments haven't worked well. Rinvoq (upadacitinib) is taken by mouth, usually once a day. It comes as an extended-release pill (Rinvoq) and an oral solution (Rinvoq LQ). These formulations aren't the same and can't be swapped easily. Side effects include nausea and a higher risk of infection.

Indications for Rinvoq

Rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in people 2 years and older
Eczema (atopic dermatitis) in people 12 years and older
Ulcerative colitis (UC) in adults
Crohn's disease (CD) in adults
Ankylosing spondylitis (AS) in adults
Non-radiographic axial spondyloarthritis (nr-axSpA) in adults
Polyarticular juvenile idiopathic arthritis (pJIA) in children 2 years and older
Giant cell arteritis in adults

Pros and Cons for Rinvoq

Pros

Can treat many different inflammatory conditions
Available as a tablet and a liquid
Tablets are taken once a day

Cons

Can raise your risk of infections
Can interact with grapefruit
Not the best option for people with severe liver or kidney problems

Common Side Effects for Rinvoq

Upper respiratory tract infection (14%)
Nausea (4%)

Warnings for Rinvoq

Serious infections
Possible higher risk of heart attack, stroke, or heart-related death in certain older adults with RA
Risk of cancer
Risk of blood clots
Allergic reactions
Stomach damage
Abnormal lab results (e.g., blood counts, cholesterol)
Harm to an unborn baby
Medication in stool