What is Kevzara (sarilumab)?
Kevzara is the brand name for the generic drug sarilumab, a type of medicine known as a biologic. Biologics are complex drugs made from living organisms or their components through genetic engineering. Unlike conventional disease-modifying antirheumatic drugs (DMARDs), which have a broad effect on the immune system, Kevzara is highly targeted. It is classified as an interleukin-6 (IL-6) receptor antagonist, meaning it specifically inhibits the signaling of the IL-6 protein, a major driver of inflammation in certain autoimmune conditions.
How Kevzara Works: Blocking the Inflammatory Signal
The body's inflammatory response is a complex system involving a variety of proteins, called cytokines. In autoimmune diseases like rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR), one of these cytokines, interleukin-6 (IL-6), is overproduced. High levels of IL-6 cause persistent inflammation, which leads to joint pain, swelling, stiffness, and damage.
Kevzara works by blocking the IL-6 receptors that are found on the surface of cells. By binding to these receptors, Kevzara prevents the IL-6 protein from attaching and triggering its inflammatory effects. This specific, targeted action helps to reduce inflammation, alleviate symptoms, and slow the progression of joint damage caused by the disease. This mechanism of action differentiates it from many other treatments, such as oral DMARDs and corticosteroids.
Conditions Treated with Kevzara
Kevzara is approved by the U.S. Food and Drug Administration (FDA) for the treatment of several inflammatory conditions in specific patient populations:
- Moderately to severely active rheumatoid arthritis (RA): For adult patients who have not responded well to, or cannot tolerate, other DMARDs. Kevzara can be used alone or in combination with other conventional DMARDs like methotrexate.
- Polymyalgia rheumatica (PMR): For adult patients who have either not responded adequately to corticosteroids or who cannot tolerate tapering off steroids. Kevzara provides an alternative to long-term corticosteroid use, which can cause significant side effects.
- Active polyarticular juvenile idiopathic arthritis (pJIA): For pediatric patients weighing 63kg or more.
Administration and Dosage
Kevzara is administered as a subcutaneous (under the skin) injection every two weeks. It is available in two forms to facilitate self-administration at home:
- Pre-filled syringe: Patients or caregivers are trained to inject the medicine.
- Pre-filled pen: This device is designed for ease of use.
Patients should rotate injection sites to prevent skin irritation. The medicine should be stored in the refrigerator but allowed to warm to room temperature before injection. A healthcare provider will determine the appropriate starting dose, which can be adjusted based on clinical response and laboratory test results.
Potential Side Effects and Safety Information
Like all medications, Kevzara can cause side effects. Due to its effect on the immune system, it carries a Boxed Warning for serious infections.
Common side effects
- Injection site reactions (redness, itching)
- Upper respiratory tract infections
- Urinary tract infections
- Nasal congestion, sore throat, and runny nose
Serious side effects
- Serious infections: These can include tuberculosis (TB), fungal, and bacterial infections, which can sometimes lead to hospitalization or death.
- Gastrointestinal perforation: Tears in the stomach or intestines have occurred, especially in patients with a history of diverticulitis or those taking NSAIDs or corticosteroids.
- Liver problems: Elevated liver enzymes can occur, and patients need regular monitoring.
- Laboratory test changes: Low white blood cell counts (neutropenia) and low platelet counts (thrombocytopenia) are possible.
- Hypersensitivity reactions: Serious allergic reactions can occur.
- Cancer: Kevzara may increase the risk of certain cancers by altering immune system function.
Patients are required to have regular blood tests to monitor for these potential issues. It is crucial to inform a healthcare provider of any signs of infection or new abdominal pain immediately.
Kevzara vs. Other Common Treatments
This table compares Kevzara with other popular treatments for conditions like rheumatoid arthritis, highlighting their distinct mechanisms of action.
| Feature | Kevzara (Sarilumab) | Humira (Adalimumab) | Rinvoq (Upadacitinib) |
|---|---|---|---|
| Drug Class | Biologic (IL-6 receptor antagonist) | Biologic (TNF-alpha inhibitor) | JAK inhibitor |
| Mechanism | Blocks the interleukin-6 (IL-6) protein from attaching to its receptors. | Blocks tumor necrosis factor (TNF-alpha), another inflammatory protein. | Blocks Janus kinase (JAK) enzymes, which are involved in the inflammatory pathway. |
| Administration | Subcutaneous injection every two weeks. | Subcutaneous injection, often every one or two weeks. | Oral tablet taken once daily. |
| Efficacy | Shown to be effective, sometimes superior as a monotherapy compared to certain TNF-alpha inhibitors like adalimumab in trials. | Well-established efficacy in multiple inflammatory conditions. | Demonstrates significant efficacy in clinical trials. |
| Key Side Effects | Serious infections, GI perforation, liver problems, neutropenia. | Infections, injection site reactions, headaches, worsening RA symptoms. | Increased risk of serious infections, blood clots, and heart-related events. |
Financial Considerations and Support
The cost of biologic medications like Kevzara can be substantial. For example, the average annual cost of Kevzara can exceed $18,000 in the U.S.. However, many manufacturers and third-party organizations offer patient assistance programs to help reduce out-of-pocket costs for eligible patients. It is important to explore these options, as well as discuss insurance coverage with a healthcare provider or pharmacist.
Conclusion
Kevzara (sarilumab) is a targeted biologic drug representing a significant advancement in the treatment of specific autoimmune diseases. By uniquely blocking the IL-6 receptor, it offers a different approach for patients, particularly those who haven't found sufficient relief from conventional therapies. While an effective treatment, it's crucial for patients to be fully informed of its potential risks, particularly the risk of serious infections. Working closely with a rheumatologist to monitor for side effects and ensure proper administration is key to safely and effectively managing these chronic inflammatory conditions.
This information is for educational purposes only and is not a substitute for professional medical advice. For more information, please consult with your healthcare provider or refer to the official Kevzara website.
