sarilumab at a glance
Medicine class
Human monoclonal antibody and interleukin-6 receptor inhibitor
Licensed uses
Selected adults with rheumatoid arthritis or polymyalgia rheumatica
How it is given
Injection under the skin using a pre-filled pen; self-injection is possible after training
Monitoring
Blood counts, liver tests, cholesterol and infection risk require review
Storage
Keep refrigerated, do not freeze and protect from light
What is sarilumab used for?
UK licensed uses represented by the selected product are:
Moderately to severely active rheumatoid arthritis in adults whose response to, or tolerance of, one or more disease-modifying antirheumatic treatments has been inadequate. It may be used with methotrexate or alone when methotrexate is unsuitable.
Polymyalgia rheumatica in adults who have responded inadequately to corticosteroids or relapsed while corticosteroids were being reduced.
How does sarilumab work?
Interleukin-6 is an immune-system signalling protein involved in inflammation. Sarilumab binds to soluble and cell-surface interleukin-6 receptors, preventing this signal from activating pathways that contribute to systemic and joint inflammation.
sarilumab preparations and strengths
Injection
Route: Parenteral
Strengths: 150 mg, 200 mg
How to take sarilumab
Use the pre-filled pen only after training from a healthcare professional. Inject under the skin and rotate between suitable areas of the abdomen, thigh or outer upper arm. Avoid tender, bruised, scarred or damaged skin.
Allow the pen to reach room temperature naturally before use; do not heat it.
Check that the solution is clear and colourless to pale yellow. Do not use a cloudy, discoloured, particulate or damaged pen.
The pen is single-use. Place it in an approved puncture-resistant container after use.
sarilumab side effects
Common or expected effects
- Low neutrophil or other blood-cell counts shown by tests
- Upper respiratory or urinary tract infections
- Cold sores
- Raised liver enzymes
- Raised cholesterol or triglycerides
- Redness or itching at the injection site
Get urgent medical advice
- Serious infection, including pneumonia or cellulitis
- Severe allergic reaction
- Persistent abdominal pain, gastrointestinal bleeding or other signs of diverticulitis or bowel perforation
sarilumab in pregnancy
Human pregnancy information is limited. Sarilumab should generally not be used during pregnancy unless the specialist considers it clinically necessary. Discuss pregnancy plans or a suspected pregnancy promptly with the prescribing team; effective contraception is advised during treatment and for the period specified in the product information after treatment ends.
sarilumab while breastfeeding
It is unknown whether sarilumab enters human milk or is absorbed by a breastfed infant. The decision to continue breastfeeding or sarilumab requires an individual specialist assessment that considers the benefits of breastfeeding, the infant's circumstances and the mother's need for treatment.
sarilumab interactions
Tell the specialist and pharmacist about all medicines and vaccinations. Important examples include:
Live or live-attenuated vaccines
Avoid during treatment because vaccine-related infection risk has not been established; vaccination status should be reviewed before starting.
Other biological antirheumatic treatments or JAK inhibitors
Combined use has not been adequately studied and may increase immunosuppression; specialist review is required.
Warfarin or theophylline
Starting or stopping sarilumab may alter their effect or concentration, so additional monitoring may be required.
Common questions about sarilumab
Answers are fully visible for fast scanning and source review.
What is sarilumab used for in the UK?
It is licensed for selected adults with rheumatoid arthritis or polymyalgia rheumatica when previous treatment has not worked adequately, caused intolerance or is otherwise unsuitable.
Is sarilumab a biological treatment?
Yes. It is a monoclonal antibody that blocks the interleukin-6 receptor.
Can sarilumab be used without methotrexate?
For rheumatoid arthritis, it may be used alone when methotrexate is not tolerated or is inappropriate.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.