Sarilumab

Information about Sarilumab

Sarilumab is a human monoclonal IgG1 antibody to the interleukin-6 (IL-6) receptor which is used in the therapy of rheumatoid arthritis and other autoinflammatory conditions.

Liver safety of Sarilumab

Sarilumab commonly causes mild serum aminotransferase elevations which are usually short lived and asymptomatic and has also been linked to rare instances of clinically apparent liver injury with jaundice.

Mechanism of action of Sarilumab

Sarilumab (sar il' ue mab) is human IgG1 monoclonal antibody to the IL-6 receptor that is used largely as therapy of refractory rheumatoid arthritis. Sarilumab binds to both soluble and membrane bound IL-6 receptors and blocks IL-6 signaling. IL-6 is a key proinflammatory cytokine that mediates a wide spectrum of biologic activities including activation of T cells, differentiation of B cells, induction of acute phase reactants, proliferation of fibroblasts, and damage to cartilage and joints. IL-6 levels are elevated in patients with active rheumatoid arthritis. In controlled trials and open label studies, sarilumab therapy led to improvements in symptoms and laboratory abnormalities in patients with rheumatoid arthritis who had an inadequate response to other disease modifying antirheumatic drugs (DMARDs).

FDA approval information for Sarilumab

Sarilumab was approved for use in the United States in 2017 for refractory rheumatoid arthritis. It is considered a DMARD, in that it improves signs and symptoms of disease and decreases cartilage and tissue destruction. Sarilumab is under evaluation in other inflammatory rheumatic diseases as well as other inflammatory autoimmune conditions, but has not been approved for these uses.

Dosage and administration for Sarilumab

Sarilumab is given in doses of 200 mg by subcutaneous injection every 2 weeks either alone (monotherapy) or in combination with other conventional DMARDs. Sarilumab is available in single dose prefilled syringes of 150 and 200 mg in 1.14 mL under the brand name Kevzara.

Side effects of Sarilumab

The most frequent side effects are upper respiratory symptoms, headache, infusion reactions and hypertension. Rare, potentially serious adverse events include serious infections, reactivation of tuberculosis and hypersensitivity reactions.

antirheumatic agents

• gold preparations
  • auranofin, gold salts, gold sodium thiomalate

• interleukin receptor antagonists
  • anakinra, canakinumab, rilonacept, sarilumab, tocilizumab

• major immunosuppressive agents (also used in transplant medicine)
  • cyclosporine, mycophenylate, sirolimus, tacrolimus

• monoclonal antibodies
  • adalimumab, canakinumab, certolizumab, golimumab, infliximab, rituximab, sarilumab, tocilizumab, ustekinumab

• thiopurines
  • azathioprine, mercaptopurine, thioguanine

• tumor necrosis factor antagonists
  • adalimumab, certolizumab, etanercept, golimumab, infliximab

• tyrosine (janus) kinase inhibitors
  • baricitinib, tofacitinib

• miscellaneous
  • abatacept, flavocoxid, hydroxychloroquine, leflunomide, methotrexate, penicillamine

• Dailymed label info on Sarilumab
• FDA Sarilumab