Xeljanz, Taltz, Orencia & Olumiant: Comparing RA Medications in the U.S

Comparing Top RA Medications 2025

Learn how RA drugs like Xeljanz, Taltz, Orencia, and Olumiant compare in treating rheumatoid arthritis. Discover which medication fits your needs based on safety, cost, and results.

​​​​​​​Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects over 1.3 million Americans, causing joint pain, swelling, and fatigue. With multiple advanced medications available in 2025, understanding how they differ is essential for choosing the best treatment plan.

Let’s take a closer look at four leading RA medications in the U.S.: Xeljanz, Taltz, Orencia, and Olumiant.


1. Xeljanz (Tofacitinib)



  • Type: JAK inhibitor (oral tablet)




  • Use: Moderate to severe RA, often after failure of TNF inhibitors




  • Pros: Oral administration, fast-acting




  • Cons: Risk of infections, blood clots, and cardiovascular concerns




  • Dosing: Once or twice daily tablet



FDA-approved for RA, psoriatic arthritis, ulcerative colitis


2. Taltz (Ixekizumab)



  • Type: IL-17A inhibitor (injectable)




  • Use: More commonly used for psoriatic arthritis and plaque psoriasis, but occasionally prescribed off-label for RA




  • Pros: Strong skin clearance for psoriatic conditions




  • Cons: Injectionsite reactions, infections




  • Dosing: Subcutaneous injection every 4 weeks




3. Orencia (Abatacept)



  • Type: T-cell co-stimulation modulator




  • Use: Moderate to severe RA not responding to TNF blockers




  • Pros: Targets early immune activation, safe long-term use




  • Cons: Slower onset of action compared to other biologics




  • Dosing: IV or subcutaneous injection weekly or monthly



Good choice for patients at high risk of infections or who failed other biologics.


4. Olumiant (Baricitinib)



  • Type: JAK inhibitor (oral tablet)




  • Use: Moderate to severe RA




  • Pros: Oral, well-tolerated, potential hair regrowth benefits (off-label)




  • Cons: Same class risks as Xeljanz (blood clots, serious infections)




  • Dosing: Once daily tablet



Also being studied and used for COVID-19 inflammation and alopecia areata.


Choosing the Right Medication

Your rheumatologist will consider:



  • Medical history and risk of side effects




  • Insurance coverage and cost-saving programs




  • Lifestyle preference (oral vs. injection)




  • Previous treatment response




Copay & Coverage in the USA



  • All four drugs offer copay assistance cards or manufacturer savings programs




  • Covered by Medicare Part D, commercial insurance, and some Medicaid plans




  • Costs can range from $5 with copay card to $4,000+/month without insurance

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