Sarilumab
KEVZARA
What it isIL-6 receptor antibody; rheumatoid arthritis and polymyalgia rheumatica.
Why this oneIt is the IL-6-receptor blocker specifically labeled for polymyalgia rheumatica when corticosteroids fail or cannot be tolerated.
What limits itIt suppresses CRP and fever, so infection can be masked. Neutropenia, transaminitis and GI perforation risk.
FDA-approved for
- rheumatoid arthritis (2017)
- polymyalgia rheumatica (2023)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Rheumatoid arthritis | Adult | 200 mg SC q2wk | 200 mg SC q2wk | 200 mg SC q2wk |
| Polymyalgia rheumatica | Adult | 200 mg SC q2wk (with tapering corticosteroids) | 200 mg SC q2wk | 200 mg SC q2wk |
| Polyarticular juvenile idiopathic arthritis (≥63 kg) | Pediatric | 200 mg SC q2wk | 200 mg SC q2wk | 200 mg SC q2wk |
Renal Undefined
Hepatic Undefined
Instructions
- Subcutaneous injection once every 2 weeks
- Do not initiate if ANC <2,000/mm3, platelets <150,000/mm3, or ALT/AST >1.5× ULN
- Avoid live vaccines
Cautions
- Serious infections — avoid during active infection
- Neutropenia, thrombocytopenia, elevated liver enzymes, lipid abnormalities
- GI perforation (higher with diverticulitis or NSAID/corticosteroid use)
- Hypersensitivity reactions
- Avoid live vaccines
Adverse reactions
- Neutropenia
- Increased ALT
- Injection-site erythema
- Upper respiratory tract infections
- Urinary tract infections
Pregnancy Insufficient human data; monoclonal antibody actively crosses placenta in 3rd trimester and may affect infant immune response
Lactation No data on presence in human milk; maternal IgG is present in milk
⚠ BOXED WARNING
- Serious infections
Cost, est. cash$1,000–$15,000+/month
Generic entry2033 est. (biosimilar)
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilitySerious infection, cytopenias, hepatic injury and malignancy risk require laboratory and clinical monitoring.
Mechanism of action: Sarilumab ballicule
Open Sarilumab in the interactive console ↗
Memory aids: mascots and interaction avatars
