Sarilumab (Kevzara)

Sarilumab (Kevzara) is a biologic medication currently approved to treat adults with moderate to severe active rheumatoid arthritis (RA). Biologic medications are proteins designed by humans that affect the immune system. Sarilumab stops inflammation by blocking a molecule called interleukin-6 receptor (IL-6R) in the immune system. This improves joint pain and swelling from rheumatoid arthritis and other symptoms caused by inflammation.

How to Take It

For adults with RA, sarilumab is given as a self-administered subcutaneous (beneath the skin) injection every 2 weeks at a dose of 200 mg. The medicine can be injected into the thigh or abdomen. The site of injection should be rotated so the same site is not used multiple times. Some patients will start to see improvement within a few weeks, but it may take several months to take full effect. Sarilumab may be taken alone or with methotrexate or other non-biologic drugs. Sarilumab should not be given in combination with another biologic drug. Blood tests will be used to monitor for changes to liver enzymes, cholesterol, and for reductions in blood cell counts while taking sarilumab.

Side Effects

Sarilumab can lower the ability of your immune system to fight infections. If you develop symptoms of an infection while using this medication, you should stop it and contact your doctor. All patients should be tested for tuberculosis before starting on sarilumab, although these types of infections have not been frequently seen. A rare complication seen with sarilumab use in clinical trials was bowel perforation, or a hole in the bowel wall. If you have a history or diverticulitis or develop abdominal pain or bloody bowel movements while taking sarilumab, you should notify your doctor immediately.

Tell Your Rheumatology Provider

You should notify your rheumatology provider if you develop symptoms of an infection, such as a fever or cough, or if you think you are having any side effects, especially abdominal pain, bloody bowel movements, or allergic reactions. Notify your doctor if you become pregnant, are planning pregnancy, or if you are breastfeeding. Be sure to talk with your rheumatology provider if you are planning to have surgery or if you plan to get any live vaccinations; these include the nasal spray flu vaccine, and others such as the measles, mumps, rubella, and yellow fever vaccines.

Updated March 2023 by Howard Yang, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condi