American College of Rheumatology (ACR) reports on emerging insights into knee osteoarthritis (OA), polymyalgia rheumatica (PMR), antiphospholipid syndrome (APS), gout, juvenile idiopathic arthritis (JIA), and rheumatoid arthritis (RA) presented at the ACR Convergence 2022 by experts including Robert Spiera, MD, rheumatologist at HSS.

PMR is one of the most common inflammatory diseases of older individuals. It can usually be treated with glucocorticoids (GC), but relapses are common, which can subject patients to long, repeating regimens of high-dose GC treatment.

“We need a steroid-sparing treatment for PMR,” said Dr. Spiera. “The phase 9 SAPHYR trial showed that sarilumab, an interleukin 6 (IL-6) receptor inhibitor, has greater and clinically relevant improvements in disease remission, risk of PMR flare, and quality of life and function compared to conventional GC treatment in this difficult-to-treat population.”

Sarilumab is currently approved by the U.S. Food and Drug Administration for. The agent targets the IL-6 receptor and inhibits IL-6 signaling.

SAPHYR randomized 59 patients to sarilumab 200 mg administered subcutaneously every two weeks with a 14-day GC taper and 58 patients to the conventional 52-week GC taper. All patients were on 7.5 mg or more GC and had a flare within 12 weeks of their initial screening. The trial was powered for 280 patients but was halted early due to COVID-19.

The primary endpoint was disease remission by week 12 and sustained through week 52, C-reactive protein normalization, and adherence to per protocol GC taper from weeks 12–52.

“This was a typical group of patients for PMR, early 70s, two-thirds female, and 80 percent white,” noted Dr. Spiera. “Sustained remission was significantly higher in the sarilumab arm, 28.4 percent versus 10.3 percent (p=0.0193). All of the components of sustained remission, patient-reported outcomes, and most physician-reported outcomes favored sarilumab with no surprises in safety. The protocol set a very high bar for sustained remission and in clinical terms, these are very significant results.” 

Read the full article at https://www.acrconvergencetoday.org/. 

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