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@dadcue

Yes! I'm glad you posted this. I was going to mention this to @abbeyc and @redboat because we were discussing Actemra which I take for PMR. There is the possibility that Actemra will stop working so I'm happy there might be an alternative to Actemra. My rheumatologist has already said Kevzara might be a possibility in the future.

Kevzara (sarilumab) and Actemra (tocilizumab) both have the same mechanism of action and both are in the same classification of medications. They are both IL-6 receptor inhibitors.

Actemra was approved by the FDA for GCA in the injectable formulation several years ago. Last year, the IV formulation was approved.

"On February 28, 2022, the FDA approved Genentech's intravenous (IV) formulation of Actemra (tocilizumab), for treatment of giant cell arteritis (GCA) in adult patients. — Previously, only the subcutaneous (SC) formulation of Actemra was approved for this indication"

Now, Kevzara has been FDA approved for PMR.

https://www.ahdbonline.com/supplements/2438-kevzara-sarilumab-a-novel-il-6-receptor-antagonist-for-rheumatoid-arthritis
I didn't want to discourage you but, TNF-inhibitors like Humira and Embrel have not been shown to be effective for the treatment of PMR. I always hope for anything that works better than long term prednisone.

We are all different snowflakes as you say. I think TNF-inhibitors are worth a try as well. I think TNF-inhibitors have worked for people who have both RA and PMR. When you have both inflammatory arthritis and PMR, things get extremely complicated.

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Replies to "Yes! I'm glad you posted this. I was going to mention this to @abbeyc and @redboat..."

Here's a paper describing a randomized control trial showing the effectiveness of Actemra (tocilizumab) against Giant Cell Arteritis. GCA is closely related to PMR, with much of the same pathology.

Compared to prednisone only, tocilizumab really helped with reducing remission , and also reduced the total adverse events.

https://www.nejm.org/doi/full/10.1056/nejmoa1613849

The graph shows the results, with % of people that did not have flares plotted as a function of time. So higher is better on the plot. The best group received tapered prednisone for 26 weeks combined with weekly injection of tocilizumab. 2nd best was prednisone plus tocilizumab. The worst results were prednisone only (26 weeks or 52 weeks.)

https://www.nejm.org/doi/full/10.1056/nejmoa1613849

There are side effects in suppressing IL-6, as tocilizumab does, but in the study the overall adverse events were (surprisingly) LESS when tocilizumab and prednisone were combined when compared with prednisone only.