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Biologic DMARD — IL-6 Receptor Antagonist

Sarilumab

Brand names: Kevzara

Sarilumab is a subcutaneously injected anti-interleukin-6 receptor monoclonal antibody used for moderate-to-severe rheumatoid arthritis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the interleukin-6 receptor, blocking IL-6-mediated pro-inflammatory signalling that drives synovial inflammation and the acute-phase response in rheumatoid arthritis.

Prescribing in practice

  • It increases the risk of serious infection (including tuberculosis), so screen for latent infection before starting and do not initiate during active infection.
  • Neutropenia, thrombocytopenia and raised liver enzymes can occur and require baseline and periodic monitoring.
  • It can lower CRP and mask the usual signs of infection, and lipid levels may rise.

Monitoring

Monitor neutrophil and platelet counts, liver function tests and lipid profile before and periodically during treatment.

Counselling the patient

  • Seek medical advice promptly if you develop signs of infection, as fever may be masked.
  • Rotate injection sites and report persistent injection-site reactions.
  • Avoid live vaccines and ensure recommended vaccinations are up to date beforehand.

Evidence & guidelines

Use is supported by NICE guidance and the SARIL-RA (MOBILITY) phase III trials.

Reference: NICE TA485; MONARCH Trial (Ann Rheum Dis 2017); SPC Kevzara; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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