Sarilumab

What it is used for

KEVZARA ® is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of: adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs (DMARDs). adult patients with polymyalgia rheumatica (PMR) who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper.

patients who weigh 63 kg or greater with active polyarticular juvenile idiopathic arthritis (pJIA). 1.1 Rheumatoid Arthritis (RA) KEVZARA ® is indicated for treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs (DMARDs).

1.2 Polymyalgia Rheumatica (PMR) KEVZARA is indicated for treatment of adult patients with polymyalgia rheumatica who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper. 1.3 Polyarticular Juvenile Idiopathic Arthritis (pJIA) KEVZARA is indicated for treatment of active polyarticular juvenile idiopathic arthritis (pJIA) in patients who weigh 63 kg or greater.

The most important thing to know

KEVZARA can cause serious side effects including: 1. Serious Infections. KEVZARA is a prescription medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body.

Some people have died from these infections. Your healthcare provider should test you or your child for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA. You should not start using KEVZARA if you have any kind of infection unless your healthcare provider says it is okay.

Before starting KEVZARA, tell your healthcare provider if you: think you have an infection or have signs or symptoms of an infection, with or without a fever, such as: sweats or chills muscle aches cough shortness of breath blood in your phlegm weight loss warm, red or painful skin or sores on your body diarrhea or stomach pain burning when you urinate or urinating more often than normal feeling very tired are being treated for an infection.

get a lot of infections or have infections that keep coming back. have diabetes, HIV, or a weak immune system. People with these conditions have a higher chance of getting infections. have TB, or have been in close contact with someone with TB. live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis).

These infections may happen more often or become more severe if you use KEVZARA. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common. have or have had hepatitis. After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.

2. Changes in certain laboratory test results. Your or your child's healthcare provider should do blood tests before you start KEVZARA, 4 to 8 weeks after starting KEVZARA, and then every 3 months during treatment to check for: low neutrophil count. Neutrophils are white blood cells that help the body fight off bacterial infections.

A low neutrophil count is common with KEVZARA, and can be severe. low platelet count. Platelets are blood cells that help with blood clotting and stop bleeding. increase in certain liver function tests. An increase in certain liver function tests is common with KEVZARA, and can be severe. Your healthcare provider may not prescribe KEVZARA if your neutrophil or platelet counts are too low, or your liver function tests are too high.

Your healthcare provider may stop your KEVZARA treatment for a period of time or change your dose if needed because of changes in these blood test results. Your or your child's healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an: increase in blood cholesterol levels.

3. Tears (perforation) of the stomach or intestines. Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.

Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away. 4. Cancer. KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer. See "

Side effects, and when to stop

" for more information about side effects. What is KEVZARA? KEVZARA is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used: To treat adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.

To treat adults with polymyalgia rheumatica (PMR) after corticosteroids have been used and did not work well or when a slow decrease in the dose of corticosteroids (taper) cannot be tolerated. To treat people with active polyarticular juvenile idiopathic arthritis (pJIA) who weigh 63 kg or more. It is not known if KEVZARA is safe and effective in children with pJIA under 2 years of age.

Who should not use KEVZARA? Do not use KEVZARA if you or your child are allergic to sarilumab or any of the ingredients in KEVZARA. See the end of this Medication Guide for a complete list of ingredients in KEVZARA. Before you or your child use KEVZARA, talk to your healthcare provider about all of your medical conditions, including if you or your child: have an infection.

have liver problems. have had stomach (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines. have recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines. All vaccines should be brought up-to-date before starting KEVZARA, unless urgent treatment initiation is required.

plan to have surgery or a medical procedure. are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby. are breastfeeding or plan to breastfeed. It is not known if KEVZARA passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA.

Tell your healthcare provider about all the medicines you or your child take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you or your child use: any other medicines to treat your RA, PMR or pJIA. You should not take rituximab (Rituxan ® ), etanercept (Enbrel ® ), infliximab (Remicade ® ), anakinra (Kineret ® ), adalimumab (Humira ® ), abatacept (Orencia ® ), certolizumab (Cimzia ® ), golimumab (Simponi ® ), tocilizumab (Actemra ® ), or tofacitinib (Xeljanz ® ) while you are using KEVZARA.

Using KEVZARA with these medicines may increase your risk of infection. medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these. Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

How should I use KEVZARA? See the detailed Instructions for Use that comes with this Medication Guide for instructions about the right way to prepare and give your KEVZARA injections at home. KEVZARA is given as an injection under the skin (subcutaneous injection). KEVZARA is available as a single-use pre-filled syringe and a single-use pre-filled pen.

Your healthcare provider will prescribe the dose and type of KEVZARA that is best for you or your child. If your healthcare provider decides that you or a caregiver can give the injections of KEVZARA at home using the pre-filled pen or pre-filled syringe, you or your caregiver should receive training on the right way to prepare and inject KEVZARA.

Do not try to inject KEVZARA until you have been shown the right way to give the injections by your healthcare provider. Inject 1 dose of KEVZARA every 2 weeks. What are the possible side effects of KEVZARA? KEVZARA can cause serious side effects, including: Serious allergic reactions. Serious allergic reactions can happen with KEVZARA.

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Storing it

Store KEVZARA in the refrigerator between 36°F to 46°F (2°C to 8°C). Store KEVZARA in the original carton until use to protect it from light. Do not freeze KEVZARA. Do not shake KEVZARA. KEVZARA may be stored at room temperature up to 77°F (25°C) for up to 14 days in the original outer carton. Throw away KEVZARA if it has been kept at room temperature and not been used within 14 days.

Keep KEVZARA and all medicines out of the reach of children.