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Kevzara and prednisone effectivness
Polymyalgia Rheumatica (PMR) | Last Active: 2 hours ago | Replies (42)Comment receiving replies
@dadcue oops. Thanks for the date corrections. I didn’t edit very well. Thank you for catching it.
Yes, Actemra was FDA approved in 2017, for GCA.
And Kevzara was approved in 2023, for PMR. The Kevzara-GCA trial was terminated before completion.
I’ve wondered many times, if Acetimra would be more effective for me. I’m just in the dark about what the switching process would entail (half-life’s, pause time, would I need to resume or restart prednisone for a period of time, etc.)
Possibly switching biologics is what started my interest in Cosentix. If I switch, which should I switch to, Actemra or Cosentix, and would I have to wait for Cosentix to be FDA approved to obtain it for PMR, and would my insurance cover either. These are questions for my rheumatologist at my Sept. appointment.
Replies to "@dadcue oops. Thanks for the date corrections. I didn’t edit very well. Thank you for catching..."
I don't think there is a significant difference between Kevzara and Actemra. The Actemra biosimilars probably work well too. I stay on Actemra because that was what I started with and it continues to work for me. I have switched from Actemra injections every 2 weeks and increased to weekly injections. I now do a monthly infusion of Actemra and that has some advantages that I like. My rheumatologist doesn't mind if I do the infusion one week early which I rarely do. When my schedule doesn't allow for an infusion exactly at every 4 weeks, I do it at 5 or 6 weeks. I have gone as long as 7 weeks between infusions but that is a little too long . I don't have a full blown flare but my pain increases a little bit and my inflammation markers become slightly elevated.
I transitioned from Actemra to Humira and back to Actemra without any problems. There weren't any gaps in treatment. When it was time for my next dose of Actemra, I did a dose of Humira instead. It was the same when I switched from Actemra injections to a monthly infusion. When it was time for my next injection, I did an infusion instead.
The nice thing about an infusion is that it is weight adjusted and can be given in any dose. My infusion dose has been adjusted by the doctor a few times. My rheumatologist asks me if the current dose is good for the whole month and he can adjust my dose up or down accordingly. Nothing changes too much so I get the same dose most of the time. The dose of an Actemra infusion can be either 4 mg per kg but can be as high as 8 mg per kg of body weight. I currently do 600 mg every 4 weeks.
Doses exceeding 600 mg per infusion are not recommended in GCA patients. I have PMR but I'm treated "as if" I have GCA.
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https://www.drugs.com/dosage/actemra.html
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"The recommended dosage of ACTEMRA for adult patients given as a 60-minute single intravenous drip infusion is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.
Reduction of dose from 8 mg per kg to 4 mg per kg is recommended for management of certain dose-related laboratory changes including elevated liver enzymes, neutropenia, and thrombocytopenia."
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@stonewheel I think your insurance would not allow anything not approved. I asked about actemra, but my rheumatologist said medicare would say no. But she also talked about rinvoq, and that's not approved, so who really knows.