The interleukin-6 inhibitor sarilumab may produce sustained remission in patients who experience relapsed polymyalgia rheumatica during glucocorticoid tapering, according to a study published by Spiera et al in The New England Journal of Medicine. In the phase III SAPHYR trial, 118 patients were randomly assigned to receive either 200 mg of subcutaneous sarilumab twice per month for 52 weeks plus a 14-week prednisone taper, or placebo plus a 52-week prednisone taper. The primary outcome of the trial was sustained remission at 52 weeks. After the follow-up period, the researchers discovered that 28.3% (n = 17 of 60) of patients who received sarilumab achieved sustained remission compared with 10.3% (n = 6 of 58) of those who received placebo. Further, compared with the placebo group, the median cumulative glucocorticoid dose at 52 weeks was lower in the sarilumab group (777 mg vs 2,044 mg). However, more patients who received sarilumab experienced adverse events such as neutropenia, arthralgia, and diarrhea. The researchers concluded that sarilumab was potentially effective at helping patients with relapsed polymyalgia rheumatica achieve sustained remission and reduce their cumulative glucocorticoid dose.
October 26, 2023