Rheumatoid arthritis (RA) is a chronic, systemic and potentially debilitating autoimmune disease that is estimated to affect over 1.3 million people in the U.S. alone1. Hallmark signs and symptoms include joint pain, fatigue and morning stiffness, though early RA tends to affect smaller joints first and can progress throughout the body2. While RA most often begins between the ages of 30 and 50, it can start at any age, according to the World Health Organization3.
If you or a loved one are looking to better understand and manage RA, check out these tips from Audrey Gibson, a board-certified physician assistant (PA).
Sanofi developed and sponsored this article and compensated Audrey for her time. The content in this article is not medical advice and is not intended to provide diagnosis or treatment for any of the medical conditions that may be discussed in this article.
Question: What challenges might individuals face when looking for the right treatment plan?
Answer: Every RA journey is unique and people living with RA have different treatment goals, which could present a challenge when it comes to a treatment course that helps manage their symptoms.
Even people who understand how the disease impacts their own health may still be working to find a treatment that is right for them. Partnering with a healthcare professional or practitioner can help individuals living with RA manage their condition and determine the best treatment path.
Q: What are the telltale signs that a treatment may not be working?
A: Oftentimes, breakthrough symptoms like fatigue, morning stiffness and joint pain can signal that a particular treatment is no longer working and it may be time to consider a new treatment.
Q: What can someone do to curb these symptoms and get on the right treatment plan?
A: Individuals living with RA should partner with their healthcare professional to understand their treatment options. They should accurately track and share their RA symptoms — including any possible breakthrough symptoms. This helps practitioners more accurately provide treatment directives and recommendations.
Q: How can someone living with RA prepare for these conversations?
A: To make the most of this discussion, I encourage people to be prepared to talk through any symptoms they are continuing to experience. Individuals living with RA should:
- Prepare a list of questions to help guide the discussion
- Keep a journal to track symptoms and bring it to every appointment
- Share photos of visible symptoms
Q: How can healthcare professionals best engage with their patients during these discussions?
A: As a PA, I aim to be empathetic and listen intentionally to support my patients in their disease and treatment journey.
If conversations with your HCP indicate that you are continuing to experience symptoms of uncontrolled RA, discuss other potential treatment options. One treatment option is Kevzara® (sarilumab), an IL-6 receptor inhibitor. USE: Kevzara is for adults with moderate to severe RA who have not been helped enough by other RA medicines. Kevzara can cause serious side effects, including serious infections. Keep reading for more information.
IMPORTANT SAFETY INFORMATION
KEVZARA® (sarilumab) can cause serious side effects including:
- SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.
- Before starting KEVZARA, tell your healthcare provider if you
- think you have an infection or have symptoms of an infection, with or without a fever. Symptoms may include sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections
- have diabetes, HIV, or a weakened immune system
- have TB, or have been in close contact with someone with TB
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis)
- have or have had hepatitis
- After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
- CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
- TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA had tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
- CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
- SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
- Do not use KEVZARA if you are allergic to sarilumab or any of the ingredients of KEVZARA.
- Before using KEVZARA, tell your healthcare provider if you
- have an infection
- have liver problems
- have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines
- recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines
- plan to have surgery or a medical procedure
- are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby
- are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk
- take any prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you use
- any other medicines to treat your RA. Using KEVZARA with these medicines may increase your risk of infection
- medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these
- The most common side effects include:
- injection site redness
- upper respiratory tract infection
- urinary tract infection
- nasal congestion, sore throat, and runny nose
These are not all of the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.
WHAT IS KEVZARA?
KEVZARA is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat adult patients with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.
To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found below, or by calling 1-844-KEVZARA (1-844-538-9272).
1) Gibofsky, A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J ManagCare. 2012 Dec;18(13 Suppl):S295302
2) World Health Organization. “Chronic rheumatic condition.” Available at: http://www.who.int/chp/topics/rheumatic/en/
3) Mayo Clinic. “Rheumatoid arthritis.” Available at: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
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