News from the FDA/CDC

FDA approves first biologic treatment for polymyalgia rheumatica


 

The Food and Drug Administration approved sarilumab (Kevzara) on March 1 for the treatment of polymyalgia rheumatica (PMR) in adults who have had an inadequate response to corticosteroids or could not tolerate a corticosteroid taper, joint developers Sanofi and Regeneron announced. The drug is the first and only FDA-approved biologic treatment for this inflammatory rheumatic disease.

The FDA previously approved sarilumab, an interleukin-6 receptor antagonist, in May 2017 for the treatment of moderate to severe active rheumatoid arthritis in adults who do not respond well or have an intolerance to disease-modifying antirheumatic drugs (DMARDs), like methotrexate.

A stamp saying "FDA approved." Olivier Le Moal/Getty Images

The FDA approval for this new indication was based on results from the multicenter, phase 3 SAPHYR trial in patients with corticosteroid-resistant, active PMR. In the randomized, double-blind, placebo-controlled study, 59 participants received 200 mg of sarilumab plus a 14-week taper of corticosteroid treatment and 58 participants received placebo every 2 weeks along with a 52-week taper of corticosteroid treatment.

After 1 year, 28% of sarilumab patients achieved sustained remission, compared with 10% of the placebo group (P = .0193). This news organization previously reported these trial results in November when they were presented at the 2022 annual meeting of the American College of Rheumatology.

The most common adverse events in the sarilumab group were neutropenia (15%), leukopenia (7%), constipation (7%), pruritic rash (5%), myalgia (7%), fatigue (5%), and injection-site pruritus (5%). Two patients had serious adverse reactions of neutropenia, which resolved after discontinuing treatment.

“Polymyalgia rheumatica can be an incapacitating disease, causing painful disease flares in multiple parts of the bodies that leave people fatigued and unable to fully perform everyday activities. Corticosteroids have been the primary treatment to date, but many patients do not adequately respond to steroids or cannot be tapered off steroids, which puts such patients at risk of complications from long-term steroid therapy,” George D. Yancopolous, MD, PhD, president and chief scientific officer at Regeneron, said in the announcement. “With the approval of Kevzara for polymyalgia rheumatica, patients now have an FDA-approved treatment to help offer relief from the disabling symptoms of this disease and long-term dependence on steroids.”

A version of this article originally appeared on Medscape.com.

Recommended Reading

Cardiovascular risk score multipliers suggested for rheumatic diseases
MDedge Internal Medicine
Belimumab for pregnant women with lupus: B-cell concerns remain
MDedge Internal Medicine
Best estimates made for hydroxychloroquine retinopathy risk
MDedge Internal Medicine
VEXAS syndrome: More common, variable, and severe than expected
MDedge Internal Medicine
75 years: A look back on the fascinating history of methotrexate and folate antagonists
MDedge Internal Medicine
Systemic sclerosis antibodies show link to interstitial lung disease in RA
MDedge Internal Medicine
Two biomarkers identify high-risk lupus nephritis
MDedge Internal Medicine
Health plans get very poor scores for access to autoimmune drugs
MDedge Internal Medicine
New tool better estimates cardiovascular risk in people with lupus
MDedge Internal Medicine
How to recognize and treat hidden inflammation
MDedge Internal Medicine