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sarilumab (Kevzara)
Indications:
- rheumatoid arthritis (FDA-approved 5/17)
- active polyarticular juvenile idiopathic arthritis (FDA-approved 6/24)
- relapsing polymyalgia rheumatica [4]
* also see IL-6 inhibitors for COVID-19
Dosage:
- 200 mg every 2 weeks
Adverse effects:
- elevated serum transaminases
- hyperlipidemia
- leukopenia, thrombocytopenia [3]
Mechanism of action:
- human monoclonal antibody, inhibits IL-6 receptor
Notes:
- superior to adalimumab (Humira) monotherapy
Management:
- whenever possible bring patients up to date on vaccinations prior to initiating biologic immunosuppressive agent [3]
Interactions
drug adverse effects of immunosuppressive agents
monitor with immunosuppressive agents
Related
interleukin-6 receptor
interleukin-6; IL-6; B-cell stimulatory factor 2; BSF-2; CTL differentiation factor; CDF; hybridoma growth factor; interferon beta-2; IFN-beta-2 (IL6, IFNB2)
General
IL-6 receptor inhibitor
biologic immunosuppressive agent (biologic agent, biologic immune modulator)
pharmaceutical monoclonal antibody
References
- Burmester GR, Lin Y, Patel R et al
Efficacy and safety of sarilumab monotherapy versus adalimumab
monotherapy for the treatment of patients with active
rheumatoid arthritis (MONARCH): a randomised, double-blind,
parallel-group phase III trial.
Ann Rheum Dis. Nov 17, 2016
PMID: 27856432 Free full text
http://ard.bmj.com/content/early/2016/11/16/annrheumdis-2016-210310.abstract
- Frellick M
FDA Approves Sarilumab for Adults With Rheumatoid Arthritis
Medscape - May 23, 2017.
http://www.medscape.com/viewarticle/880473
- Medical Knowledge Self Assessment Program (MKSAP) 19
American College of Physicians, Philadelphia 2022
- Spiera RF et al.
Sarilumab for relapse of polymyalgia rheumatica during glucocorticoid taper.
N Engl J Med 2023 Oct 5; 389:1263.
PMID: 37792612
https://www.nejm.org/doi/10.1056/NEJMoa2303452