People with rheumatoid arthritis often take medicines to help manage their condition and improve their symptoms. Some of these medicines work directly on the body’s immune system and help to limit the swelling (inflammation) that causes damage to the joints over time.
Some people will be able to manage their condition with oral medicines. Others may use medicines that are injected into the body. One of these medicines, called Kevzara, has been shown to help improve symptoms in people who do not get enough benefit from oral medicines and certain types of injected medicines.
How Does Kevzara Work for Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a type of autoimmune condition, which means that the body’s immune cells attack its own healthy cells. In people with RA, their immune systems attack the lining in their joints, which causes swelling (inflammation). This can cause the joints to become red, warm, stiff, and painful. Over time, the swelling can cause permanent damage, which can make the joints very painful and difficult to use.
Most people with RA have issues with the same joints on both sides of the body. For example, if one knee is affected, the other knee is usually also affected. Although RA may start in only a couple of joints, it can spread to other joints if it is not treated. It most commonly causes issues in the wrists, hands, elbows, shoulders, feet, and knees.
If a person with RA is having symptoms, their disease is considered “active.” Some people with this condition will have periods of “remission,” when the pain or stiffness goes away for some length of time. Everyone with RA has a different experience. For example, some people will have their symptoms come and go over time. Others will have “flare-ups,” where symptoms become much worse. These flare-ups may be due to stress, too much activity, or changes in treatment.
The key to treating RA is to reduce the swelling in the joints. This can help reduce pain and stiffness. It can also help prevent permanent damage to the joints. It is important to start treatment for RA as soon as possible after receiving a diagnosis, so that the damage to the joints does not become severe.
There are many medicines available that help stop the immune system from attacking its own cells and causing swelling. Since these medicines prevent damage to the joints over time, they are called disease-modifying antirheumatic drugs (DMARDs). Some of these medicines are taken by mouth and others are injected into the body. People with RA often take more than one DMARD. They may also take other medicines to help manage the pain and swelling in their joints.
Kevzara is a DMARD that is injected into the body. The main ingredient in Kevzara is called sarilumab. This medicine works by blocking a substance in the body, called interleukin-6 (IL-6), from working. Blocking IL-6 from working can decrease the swelling in the joints, preventing damage and reducing pain and stiffness.
Can Anyone With RA Use Kevzara?
Many people with RA will first try an oral DMARD to manage their condition. Some may also try an injected DMARD. In some cases, these medicines may not improve symptoms or stop the damage to the joints. If you have moderate or severe RA and still have a lot of symptoms even when using an oral or injected DMARD, Kevzara may be an option for you.
Kevzara may not be a safe option for everyone. It is important to speak with your health care professional about any past or current medical conditions, especially specific conditions such as diverticulitis or liver problems. It is also important for your health care professional to know if you have recently traveled to certain parts of the U.S. or to other countries, or if you have been around someone who has had a serious infection, such as tuberculosis (TB).
How Was It Studied?
Two studies were done to see if Kevzara is safe and effective for the treatment of RA. Everyone in these studies had active RA even though they were already using an oral DMARD. Some of the oral DMARDs that people had used were hydroxychloroquine, leflunomide, methotrexate (MTX), and sulfasalazine. In one of the studies, all of the patients had also tried and failed a type of therapy called anti-TNF therapy, which blocks a substance in the body called tumor necrosis factor (TNF). Some examples of these medicines are adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade).
Everyone in these studies was at least 18 years old, with an average age of about 52. Most of the people (about 82%) were female, and most (about 81%) were White. About 6% were Asian, and less than 5% were Black. The people in these studies had at least eight tender joints and at least six swollen joints. They had been diagnosed with RA about 9-12 years, on average, before the study started.
In both of these studies, Kevzara was compared with a placebo. No one knew whether they were using the medicine or the placebo. Everyone was told to continue taking their oral DMARD during the study.
These studies measured efficacy in multiple ways:
- The number of people who had their symptoms improve by at least 20%. This was done by counting the number of tender and swollen joints for each person. Patients and health care providers were also asked to rate symptoms on a scale. These measures were taken before the study and after 6 months into the study.
- The results of a survey that measures how much a person’s symptoms affect their daily life. This survey, called the Health Assessment Questionnaire - Disability Index (HAQ-DI), asks people about their ability to do normal activities each day, as well as their pain levels. People completed this survey before the study started and after 3 months into the study.
- The amount of damage to the joints that can be seen on an X-ray or CT scan. This was measured before the study and after a year into the study.
What Benefits Were Seen in These Studies?
- After about 3 months into the study, the people who used Kevzara had more improvements in their daily function than the people who used a placebo.
- After 6 months into the study, more people who used Kevzara had their symptoms improve by at least 20% than the people who used a placebo.
- After a year into the study, the people who used Kevzara did not have as much damage to their joints, as seen on an X-ray or CT scan, as the people who used a placebo.
This means that the people who used Kevzara had fewer symptoms, had less damage to their joints, and were able to function better on a daily basis than the people who used a placebo.
How Quickly Will Kevzara Work for RA?
If Kevzara is working, your symptoms will start to improve within the first 1-2 months of treatment. Your symptoms may continue to improve over the next few months as well. Do not stop using Kevzara or any other medicines for RA without talking to your health care provider first, even if your symptoms have gotten better. Your symptoms may get worse again if you stop or change any of your medicines.
Tell your health care provider if Kevzara does not seem to be improving your symptoms after about 3 months. Your health care provider may discuss other options for treating this condition.
How Do I Use It?
Kevzara is a liquid that is injected under the skin every other week. It can be injected into the thigh, stomach, or outer area of the upper arm. The medicine is stored in the refrigerator. To make the shot more pleasant, it is helpful to let the medicine warm up to room temperature for 30 minutes before using it.
The medicine comes in two forms. The most common form is a pre-filled device that is ready to inject the medicine under the skin, so you do not need to learn how to use a syringe and needle. The medicine also comes in a pre-filled syringe with a needle. In either case, your health care provider will show you how to inject the medicine before you use it the first time.
It is important to inject the drug properly so that you get the right dose. Your prescription should come with “Instructions for Use,” which explains how to prepare and give a dose. Ask your pharmacist or other health care provider if you are unsure how to use Kevzara.
How Can I Prevent or Manage Side Effects?
Kevzara can cause a skin reaction where you get the shot, which may involve redness, itching, and swelling. One way to reduce these reactions is to inject the drug into a different part of the body each time, which is called “rotating” the injection site. For example, Kevzara can be injected into different parts of the thigh, stomach, or outer area of the upper arms. Don’t inject the drug into skin that is already tender, damaged, bruised, or scarred.
People who use Kevzara are more likely to have infections, especially an infection of the airways. These include sinus infections, infections in the nose or throat, a sore throat, or common cold symptoms. The best way to prevent infection is to reduce your exposure to germs by washing your hands and avoiding people who are sick. You should also stay current on vaccinations, such as getting an annual flu vaccine. Before you start Kevzara, speak with your health care professional about whether you are due for any vaccines.
Some types of microbes that cause infections (such as viruses and bacteria) can stay in the body even after you have recovered from an infection. When this happens, the microbes are “latent,” which means that they are not active and do not cause infection. In some cases, Kevzara may cause these microbes to reactivate and cause a new infection. Before starting treatment with Kevzara, it is important to let your health care provider know if you have had any serious infections in the past, such as tuberculosis (TB), hepatitis B, or histoplasmosis. You and your health care provider can discuss a plan to use Kevzara safely or to consider other treatment options.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Kevzara, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Are There Any Interactions With Other Medicines?
Kevzara may change the blood levels of some other medicines. It is important for your health care provider to be aware of all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. It is especially important to let your health care provider know if you are using any other medicines that may affect the function of your immune system.
Are There Any Interactions With Vaccines?
It is important to discuss any recent or upcoming vaccines (immunizations) with your health care provider. There are certain vaccines (“live” vaccines) that you should not receive either right before starting Kevzara or once you have already started using Kevzara. Your health care provider will confirm whether any recent or upcoming vaccines are safe.
Are There Any Special Steps Required to Get Kevzara?
Kevzara is a “specialty” medicine. This means that you may need to get it from a specialty pharmacy and that it may require prior authorization from your insurance company. Your first dose of Kevzara will always be given by a health care provider in a health care setting.
Is There a Coupon Card Available?
There is a savings coupon available from the drugmaker that may allow you to pay $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance, and what type of insurance you have. You can find out more at https://www.kevzara.com/ra/resources/kevzaraconnect-copay-card.
