Sarilumab for Rheumatoid Arthritis

Sarilumab or Kevzara is an injectable prescription medicine used to treat moderate to severely active rheumatoid arthritis (RA) in adult patients. It can be used only after at least one other medicine called DMARD has been used and did not work well.

It works by inhibiting interleukin-6 (IL-6).

Sarilumab comes in a pre-filled pen or syringe that you self-inject once every 2 weeks. Depending on your doctor, it can be taken with or without methotrexate. Do not try to inject your sarilumab prefilled syringe until you have been shown the right way to give sarilumab injections by a healthcare provider.

Sarilumab, taken with methotrexate, has been proven to:

• Relieve pain in 2 weeks, for some people it may take 3 months
• It helps to reduce swollen and tender joints
• It helps to slow the progression of RA and this prevents the joints from further damage

What this means is that you may be able to perform those everyday activities like making dinner, going for a swim, or taking a long walk.

• Injection site reactions, urinary tract infection, upper respiratory tract infection, nasal congestion, sore throat, and runny nose are some of the most common side effects.

• Serious infections: sarilumab is a medicine that affects your immune system and lower’s the ability of your immune system to fight infections. Serious infections like tuberculosis and infections caused by bacteria, fungi, or viruses can also happen during and after treatment with sarilumab. Some people may die from these infections. Your doctor will test you for TB before starting sarilumab. Your doctor should monitor you for signs and symptoms of TB during treatment with sarilumab.
  • Before starting treatment with sarilumab, tell your doctor if you
    • think you have an infection or symptoms of an infection (with or without a fever). Symptoms may include blood in your phlegm, burning when you urinate weight loss, warm, red, or painful skin or sores on your body, sweats or chills, muscle aches, coughness, shortness of breath, diarrhea or stomach pain, urinating more often than normal, if you feel very tired than usual, or get a lot of infections, have repeated infections, if you are currently being treated for an infection
    • have a weak immune system, diabetes, or HIV
    • have lived, currently live, or have traveled to certain parts of the country (such as Ohio, Mississippi River valleys, and Southwest) where there is an increased chance of getting certain fungal infections like histoplasmosis, blastomycosis, or coccidioidomycosis)
    • have TB, or have been in close contact with someone with TB
    • have or have had hepatitis
  • After starting sarilumab, call your doctor if you have any symptoms of an infection.

• Changes in laboratory test results: before and after starting sarilumab, Your doctor will conduct blood tests to check for low neutrophil (white blood cells that fight off bacterial infections) counts, low platelet counts, and an increase in certain liver function tests. Changes in test results are common with sarilumab. You may also have changes in other laboratory tests, like your blood cholesterol levels. Your doctor should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.

• Cancer: sarilumab may increase your risk of cancer by changing the way your immune system works. Tell your healthcare provider if you have had any type of cancer.

• SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can also happen with sarilumab. If you have any of the following signs: feeling dizzy or faint; shortness of breath or trouble breathing; swelling of your lips, tongue, or face; moderate or severe stomach pain or vomiting, or chest pain.

• Tears of the stomach or intestines: Tell your healthcare provider if you had a condition called diverticulitis (inflammation in parts of the large intestine), ulcers in your stomach, or intestines. Some people using KEVZARA had tears in their stomach or intestine. This happens in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate. Call your doctor right away if you have fever and stomach (abdominal) pain that does not go away.

• Do not use sarilumab if you are allergic to sarilumab or any of the ingredients of sarilumab.

• Before using sarilumab, tell your doctor if you
  • have an infection
  • have liver problems
  • have had stomach pain or a condition known as diverticulitis (inflammation in parts of the large intestine), ulcers in your stomach, or intestines.
  • are scheduled to receive a vaccine or recently received a vaccine. People who take KEVZARA should not receive live vaccines and should postpone the date for taking live vaccines.
  • plannning to have surgery
  • are pregnant or planning to become pregnant. It is not known if KEVZARA will harm your unborn baby
  • are breastfeeding or planning to breastfeed. Sarilumab may pass into your breast milk. and make sure to not breastfeed during treatment.
  • If you are taking any medications, prescriptions, over-the-counter medicines, vitamins, and herbal supplements including
    • other medicines to treat your RA. Using sarilumab with these medicines may increase your risk of infection.
    • medicines that affect the way certain liver enzymes work.

• Store sarilumab in the refrigerator at 36°F to 46°F.
• Store sarilumab in the original carton until used to protect it from light.
• Do not freeze or shake sarilumab.
• Sarilumab may be stored at room temperature up to 77°F (25°C) for up to 14 days in the original outer carton.
• Throw away sarilumab if it has been kept at room temperature and has not been used within 14 days.