Team: SAPHYR

Base Article: Spiera RF, Unizony S, Warrington KJ, et al. Sarilumab for Relapse of Polymyalgia Rheumatica during Glucocorticoid Taper. N Engl J Med. 2023;389(14):1263-1272. doi:10.1056/NEJMoa2303452

Authors: The Medical University of South Carolina Fellowship Program

1. Jessica English, MD, 3^rd year fellow
2. Lauren Berry, MD, 2^nd year fellow
3. Rachael Werner, MD, PhD, 2^nd year fellow
4. Jake Altier, MD, 2^nd year fellow
5. Gretchen Santana, MD, 1^st year fellow
6. Rashi Vora, MD, 1^st year fellow
7. Faye Hant, DO, Program Director

Team Overview

Lace up those sneakers and whip off your warmup suit, because the NEJM SAPHYR study on Sarilumab for Relapse of Polymyalgia Rheumatica during Glucocorticoid Taper is not just a game; it’s a “gem” of a trial and the BIG DANCE that’s making PMR rethink its moves!

In this biochemical court, sarilumab takes charge, showcasing its anti-inflammatory moves like a point guard with pinpoint accuracy. It’s late in the third quarter and team placebo/glucocorticoid taper (58 patients, 52 week taper) has met its randomized, double blind match against sarilumab/short glucocorticoid taper (600 patients, 14 week taper), armed with its signature interleukin-6 receptor inhibition, giving the team a much-needed boost. It’s a full court press with sarilumab boxing out the inflammatory offense, spreading the zone and evading screens. Sarilumab works on both sides of the ball, juking out those inflammatory cytokines and taking it straight to the hole – allowing for sustained remission of PMR signs and symptoms in 28% of its players (17/60 patients) versus 10% of its opponent placebo team (6/58 patients, difference 18%; 95% CI 4-32; P=0.02) while needing only a third of the amount of cumulative glucocorticoids compared to placebo (777 mg vs 2044 mg; P<0.001). Nothing but net! Sarilumab is the breakout rookie of the year orchestrating these anti-inflammatory plays.

The study isn’t just turning the page on polymyalgia rheumatica; it’s rewriting the playbook on medical challenges with a pharmacological play that’s leaving providers and patients alike high fiving in the clinic.

Game on!

Want to learn more?

See the Q&A on theMednet.org about the following question: What characteristics make a patient with PMR a good candidate for sarilumab?

Next report: Comparing ULT

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