Sarilumab

Sarilumab is a type of drug called a biological therapy. It’s sometimes known by its trade name, Kevzara.

它可以由顾问风湿病学家为了rheumatoid arthritis。如果您患有类风湿关节炎，您的身体可能会产生过多的称为IL-6的蛋白质，会影响您的免疫系统。Sarilumab通过阻止IL-6来起作用。

Inflammation is your immune system’s way of fighting infections in your body. Inflammation can cause swelling, heat, redness and pain – you might notice these signs when you have a cut or a wound.

在类风湿关节炎中，免疫系统会误认为您的身体健康部位，例如关节，并引起炎症。这会导致疲倦，贫血和骨骼，软骨和软组织的损害。

Sarilumab是一种长期治疗，可能在两周到12周之间注意到症状有所改善。

这可能是您给予的第一种生物疗法，或者您可能首先尝试过其他人，例如rituximab或者an anti-TNF drug.

Are there any reasons I won't be prescribed sarilumab?

如果：

• your arthritis isn’t active
• 你有感染
• you haven’t tried two disease-modifying anti-rheumatic drugs (DMARDs), such as甲氨蝶呤和hydroxychloroquine, first.

Usually, sarilumab will be prescribed in combination with methotrexate.

Doctors sometimes use a score known as DAS28 to work out how active your arthritis is. This counts how many of 28 specific joints are tender and swollen, and looks at inflammation levels in a blood test. You'll also be asked to score how well you feel on a scale of 0 to 10 (DAWN).

您的医生可能会决定不开sarilumab如果您：

• 重复或严重感染
• 胆固醇高，或者血液中的某些脂质或脂肪含量高
• have a liver disease, or if your liver function tests are higher than the normal range
• have a history of intestinal ulcers or diverticulitis
• 患慢性肾脏疾病
• have or have had any type of cancer.

在开始Sarilumab之前，您将进行胸部X射线检查和血液检查，以检查您以前是否暴露于结核病（TB）。即使您没有任何症状，也可能需要在开始萨里卢马布之前对结核病的治疗方法。

You’ll also be checked to see if you have previously had hepatitis, as sarilumab can increase the risk of hepatitis starting up again.

Sarilumab is given as an injection under the skin, known as a subcutaneous injection, once every two weeks. This is done using either a pre-filled syringe or an injector pen.

You, your partner, or another member of your family can learn to give these injections.

除非您有严重的副作用，否则请继续服用sarilumab。您应该继续服用它，即使它一开始似乎没有工作，何时症状开始改善，因为这将有助于控制您的关节炎。

如果您错过了一剂sarilumab并在三天之内意识到，则应尽快服用，然后按计划服用下一个剂量。如果自错过剂量以来已经四天或更长时间了，请不要服用sarilumab - 只要下一个剂量即可。

The most common side-effects aren’t usually serious – they include:

• a cough or sore throat
• 阻塞或流鼻涕
• 唇疱疹
• urinary tract infections
• 注射部位发红和瘙痒。

Sarilumab can make you more likely to pick up infections and it can also make them harder to spot. Tell your doctor or rheumatology nurse if you develop a sore throat or fever, or have unexplained bruising, bleeding or paleness. You should also tell them if you have any other new symptoms.

如果这些症状中的任何一个很严重，您应该停止服用sarilumab，立即去看医生。Sarilumab有两种优势，因此，如果您的副作用严重，则可能会减少剂量。

You should also see your doctor if you develop chickenpox or shingles, or come into contact with someone who has chickenpox or shingles, as these can be severe if you’re on sarilumab. You may need antiviral treatment, and your sarilumab may need to be stopped until you’re better.

Sarilumab有时会增加您的胆固醇水平，您可能需要要求GP进行治疗以降低这些水平。它还可以影响肝功能测试或减少血液中白细胞或血小板的数量。

您需要在萨里卢马布（Sarilumab）进行脂肪的情况下每四到八周进行一次胆固醇检查和血液检查，以监测其效果。

降低感染的风险

尽量避免与患有严重感染的人密切接触。

For advice on avoiding infections from food, read NHS Live Well's防止食物中毒的10种方法。

You shouldn’t use sarilumab if you’re taking any other type of biological therapy, but it can be prescribed alongside other drugs, including甲氨蝶呤。

Check with your doctor before starting any new medications, and remember to mention you’re on sarilumab if you’re treated by anyone that isn’t in your usual风湿病团队。

告诉您的医生，您是否正在服用他汀类药物，口服避孕药或用于治疗哮喘或血凝块的药物，因为Sarilumab可以与其中一些药物相互作用。

You can carry on takingnon-steroidal anti-inflammatory drugs (NSAIDs)或者止痛药if needed, unless your doctor advises otherwise. Don’t take over-the-counter or herbal remedies without talking to your rheumatology team first.

建议您携带生物疗法警报卡，因此任何对待您的人都会知道您在Sarilumab上 - 您可以从风湿病部门获得一张卡。

Vaccinations

Sarilumab上的人们应避免使用诸如黄热病之类的活疫苗。

带状疱疹疫苗(Zosta生活vax) isn’t recommended for people taking sarilumab. However, there is a non-live shingles vaccine (Shingrix) so you may be able to have this instead.

Having an operation

If you’re having an operation, you may be advised to stop taking sarilumab for a few weeks before and after surgery – check with your rheumatology team or surgeon about this.

There’s no reason to avoid alcohol while on sarilumab, but you should stay within government guidelines for adults of no more than 14 units per week. You should try to spread these units out over the week, and not have them all in one go .

Because sarilumab is a relatively new drug, we don’t yet know how it might affect pregnancy or an unborn baby. Tell your rheumatology team immediately if you become pregnant whilst taking sarilumab.

如果您是育龄的女性，那么在服用萨里卢马布（Sarilumab）的同时，在完成治疗后三个月使用避孕是一个好主意。有证据表明，萨里卢马布（Sarilumab）可能会影响避孕药的工作原理，因此，请告诉医生，当您开始使用Sarilumab时服用药丸，因为他们可能会建议您可以使用其他形式的避孕药。

我们还不知道Sarilumab是否可以进入母乳，因此目前的建议不是服用这种药物时母乳喂养。