What is Sarilumab: Uses, Dosage, Side Effects and More

Sarilumab is a prescription medication that helps reduce inflammation in people with rheumatoid arthritis and other autoimmune conditions. It's given as an injection under the skin, similar to how people with diabetes give themselves insulin shots.

This medication belongs to a group called IL-6 inhibitors, which work by blocking specific signals in your immune system that cause joint pain and swelling. Think of it as turning down the volume on your body's overactive immune response.

What is Sarilumab?

Sarilumab is a biologic medication that targets interleukin-6 (IL-6), a protein that drives inflammation in your body. When you have rheumatoid arthritis, your immune system produces too much IL-6, leading to painful, swollen joints.

The medication comes as a pre-filled pen or syringe that you inject under your skin every two weeks. It's manufactured using advanced biotechnology, which means it's made from living cells rather than traditional chemicals.

Your doctor will typically prescribe sarilumab when other arthritis medications haven't provided enough relief. It's considered a targeted therapy because it focuses on one specific part of the immune system rather than suppressing your entire immune response.

What is Sarilumab Used For?

Sarilumab is primarily used to treat moderate to severe rheumatoid arthritis in adults. It helps reduce joint pain, stiffness, and swelling that can make daily activities challenging.

Your doctor might recommend sarilumab if you haven't responded well to methotrexate or other disease-modifying antirheumatic drugs (DMARDs). It can be used alone or combined with methotrexate for better results.

The medication is also being studied for other inflammatory conditions, though rheumatoid arthritis remains its main approved use. Your healthcare provider will determine if sarilumab is right for your specific situation based on your symptoms and medical history.

How Does Sarilumab Work?

Sarilumab works by blocking interleukin-6 receptors in your body. IL-6 is like a messenger that tells your immune system to create inflammation, even when it's not needed.

When sarilumab attaches to these receptors, it prevents IL-6 from sending inflammatory signals. This helps reduce the joint damage, pain, and swelling associated with rheumatoid arthritis.

The medication is considered moderately strong among biologic treatments. It's more targeted than steroids but still powerful enough to significantly impact your immune system. Most people start noticing improvements within 2-4 weeks of starting treatment.

How Should I Take Sarilumab?

Sarilumab is given as a subcutaneous injection, which means you inject it into the fatty tissue just under your skin. The standard dose is 200mg every two weeks, though your doctor might start with 150mg if you have certain health conditions.

You can inject sarilumab into your thigh, upper arm, or abdomen. Rotate injection sites each time to prevent skin irritation. The medication should be at room temperature when you inject it, so take it out of the refrigerator 30-60 minutes beforehand.

You don't need to take sarilumab with food since it's injected rather than swallowed. However, it's important to inject it on the same day every two weeks to maintain steady levels in your system.

Your healthcare provider or a nurse will teach you how to give yourself the injection. Most people find it easier than they expected, and the pre-filled pens make the process straightforward.

How Long Should I Take Sarilumab For?

Sarilumab is typically a long-term treatment for rheumatoid arthritis. Most people continue taking it as long as it's helping their symptoms and not causing serious side effects.

Your doctor will monitor your response over the first few months to see how well the medication is working. If you're experiencing significant improvement, you'll likely continue with regular injections.

Some people may need to take sarilumab for years to maintain their symptom control. However, your healthcare provider will regularly review your treatment to ensure it's still the best option for you.

Never stop taking sarilumab suddenly without talking to your doctor first. Your symptoms might return if you discontinue the medication abruptly.

What Are the Side Effects of Sarilumab?

Like all medications, sarilumab can cause side effects, though not everyone experiences them. Understanding what to watch for can help you feel more confident about your treatment.

Here are the most common side effects you might experience:

• Injection site reactions like redness, swelling, or mild pain
• Upper respiratory infections such as colds or sinus infections
• Headaches that are usually mild to moderate
• Increased cholesterol levels, which your doctor will monitor
• Elevated liver enzymes, detected through blood tests

These common side effects are generally manageable and often improve as your body adjusts to the medication.

Some people may experience more serious but less common side effects that require immediate medical attention:

• Serious infections that could be life-threatening
• Severe allergic reactions with difficulty breathing or swelling
• Significant drops in white blood cell or platelet counts
• Liver problems causing yellowing of skin or eyes
• Bowel perforation, though this is extremely rare

While these serious side effects are uncommon, it's important to contact your healthcare provider immediately if you experience any concerning symptoms.

Who Should Not Take Sarilumab?

Sarilumab isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. Certain conditions or situations make this medication potentially dangerous.

You should not take sarilumab if you have any of these conditions:

• Active infections, including tuberculosis or hepatitis B
• Severe liver disease or significantly elevated liver enzymes
• Very low white blood cell or platelet counts
• Known allergies to sarilumab or any of its ingredients
• Live vaccines scheduled within the next few weeks

Your doctor will also use extra caution if you have a history of recurring infections, recent surgery, or other immune system disorders.

Pregnancy and breastfeeding require special consideration. While sarilumab hasn't been extensively studied in pregnant women, your doctor will weigh the benefits against potential risks if you're planning to become pregnant or are already expecting.

Sarilumab Brand Names

Sarilumab is marketed under the brand name Kevzara in the United States and most other countries. This is the only brand name currently available for this medication.

Kevzara is manufactured by Sanofi and Regeneron Pharmaceuticals. The medication comes in pre-filled pens and syringes for easy self-injection at home.

Unlike some other medications, there isn't a generic version of sarilumab available yet. This means Kevzara is currently the only option if your doctor prescribes sarilumab.

Sarilumab Alternatives

If sarilumab isn't right for you, several other biologic medications can treat rheumatoid arthritis effectively. Your doctor might consider these alternatives based on your specific needs and medical history.

Other IL-6 inhibitors include tocilizumab (Actemra), which works similarly to sarilumab but is given as an infusion or injection. TNF inhibitors like adalimumab (Humira) or etanercept (Enbrel) target different inflammatory pathways.

JAK inhibitors such as tofacitinib (Xeljanz) or baricitinib (Olumiant) are oral medications that can be easier for some people to take. Traditional DMARDs like methotrexate or sulfasalazine remain important treatment options, especially for people just starting arthritis treatment.

Your healthcare provider will help you choose the best alternative based on your symptoms, other health conditions, and treatment preferences.

Is Sarilumab Better Than Tocilizumab?

Sarilumab and tocilizumab are both IL-6 inhibitors, which means they work in very similar ways to reduce inflammation. Comparing them directly can be tricky because they haven't been tested head-to-head in large studies.

Both medications are highly effective for treating rheumatoid arthritis, and many people do well with either option. The choice often comes down to practical factors like how the medication is given and your personal preferences.

Sarilumab is only available as a self-injection every two weeks, while tocilizumab can be given as either an infusion every four weeks or a weekly injection. Some people prefer the convenience of self-injection, while others like the less frequent dosing of infusions.

Your doctor will consider your specific situation, including other medications you're taking and any side effects you've experienced, to help determine which option might work better for you.