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PMR on Kevzara — Normal CRP but Still in Pain?
I’m curious if anyone with PMR who is taking Kevzara has experienced this. My blood work, including C-reactive protein, is now in the normal range, which suggests the inflammation is under control. Yay! However, I’m still dealing with noticeable pain and stiffness, particularly in my hands. Has anyone else had normal labs while still experiencing symptoms while on Kevzara? I'm also still on 5 mg of prednisone. I’d be interested to hear how common this is and what others’ experiences have been.
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You don’t say how long on Kevzara…..it can take up to 3 months to work.
I was at 8 pred when I started, conservative taper over 3.5 months led me to pain free at same time as taper done. Then Tylenol for arthritis to supplement as needed until adrenals recovered.
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2 ReactionsTapering prednisone gets more difficult when you get to 7 mg or less. There are several reasons why you might have pain even with being on Kevzara. You can’t assume all pain is caused by PMR.
CRP is an indirect measure of inflammation as compared to a more direct measure. You will immediately see a drop in CRP levels when Kevzara is started. However since CRP doesn’t directly measure inflammation it is possible that inflammation is still present.
It is complicated but yes … you can still have pain on 5 mg of prednisone with a normal CRP level when Kevzara is started. That would be common and not unexpected.
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4 ReactionsI asked artificial intelligence (AI) about your question. This is how AI explained it:
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Yes, the situation described is common and medically expected when treating inflammatory conditions like Polymyalgia Rheumatica (PMR) or Rheumatoid Arthritis (RA) with Kevzara (sarilumab).
Here is the breakdown of why this happens:
1. CRP is an Indirect Marker
C-reactive protein (CRP) is produced by the liver in response to inflammatory cytokines, particularly Interleukin-6 (IL-6). It is a downstream marker, meaning it tells you that inflammation was present, but it does not directly measure the active immune cells or the tissue damage itself.
2. Kevzara Drops CRP Rapidly
Kevzara is an IL-6 receptor antagonist. It blocks the signaling of IL-6, which is the primary driver for the liver to produce CRP. When you start Kevzara, you are cutting off the signal to the liver, causing CRP levels to plummet or "normalize" very quickly, often within two weeks.
Crucial Point: A low or normal CRP while on Kevzara means the liver has stopped producing CRP, but it does not mean the underlying autoimmune disease (the inflammation in your joints or muscles) is completely gone.
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3 Reactions@tweetypie13 Thank you. It'll be three months in two weeks. It's helping - just surprised that my c-reative is normal, but I still have pain.
@dadcue Thank you so much. Very helpful.
@dadcue Thank you! So appreciate your response and the education 🙂
@cheraloha
PS: you have to determine if it’s PMR pain, adrenal suppression, activity pain etc. Often times my discomfort came from activity or using body in ways that has been inactive,
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1 Reaction@tweetypie13 Thank you. One of the hardest things about this is connecting the dots 🙂
@cheraloha
Good luck.
If you can connect the dots…..YOU QUALIFY FOR MILLIONAIRE OF THE MOMENT. The dots chg color and move the pattern from person to person.
Keep a daily journal, pain level, meds, activities……it helps to evaluate your path.
Have faith
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1 Reaction@tweetypie13 Thank you and faith is what has sustained me thus far!