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Sarilumab

Class
Biologic agents
Subclass
Anti-IL-6R monoclonal antibodies
Substance name
Sarilumab
Brand names
Kevzara®
Dosage and administration
Adults patients
JIA • Polyarticular
Weight > 63 kg
•
200 mg SC q2 weeks
Rheumatoid arthritis • Moderate-to-severe, active
•
200 mg SC q2 weeks
Other off-label uses
•
Treatment of COVID-19 infection (severe)
Indications for use
Labeled indications
Adults
•
Treatment of JIA (polyarticular)
•
Treatment of polymyalgia rheumatica (inadequate response to corticosteroids or unable to tolerate corticosteroid taper)
•
Treatment of rheumatoid arthritis (moderate-to-severe, active)
Off-label indications
Adults
•
Treatment of COVID-19 infection (severe)
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. The limited human data with this drug in pregnant women are not sufficient to inform drug-associated risk for major birth defects and miscarriage.
•
Monoclonal antibodies are actively transported across the placenta during the third trimester of pregnancy and may affect immune response in the in utero exposed infant.
•
Levels of IgG, in response to antigen challenge, may be reduced in the fetus/infant of treated mothers.
Breastfeeding
Acceptable for use during breastfeeding.
•
Use with caution during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Unlikely to cause adverse effects in breastfed infants.
Adverse reactions
Very common > 10%
•
↓ blood neutrophil count, nasopharyngitis, injection site reactions, upper respiratory tract infections
Common 1-10%
•
↓ WBC count, ↓ blood monocytes, ↓ platelet count, herpes simplex virus infection, herpes zoster, ↑ serum ALT, ↑ serum triglycerides, constipation, fatigue, itching, myalgia, urinary tract infections
Unknown frequency
•
Active tuberculosis, allergic reactions, carcinogenesis, gastrointestinal perforation, ↑ serum HDL, ↑ serum LDL, ↑ serum total cholesterol, infections, ⊕ rapid antibody test
Interactions
Drug(s)
Check Interactions
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