Journal Club Review: Sarilumab for Relapse of Polymyalgia Rheumatica During Glucocorticoid Taper

In this journal club episode, Jeannette Hart, PA-C—co-founder of PNW Arthritis and Rheumatology and practicing at Kadlec Regional Medical Center in Washington—reviews pivotal findings from the SAPPHIRE trial, which led to the FDA approval of sarilumab for the treatment of polymyalgia rheumatica (PMR). Published in the New England Journal of Medicine in October 2023, this phase 3 randomized controlled trial evaluated the efficacy and safety of IL-6 receptor blockade with sarilumab in patients with PMR who relapsed during glucocorticoid tapering. Jeannette outlines key study design elements, inclusion/exclusion criteria, primary and secondary endpoints, and statistical outcomes—highlighting how sarilumab significantly increased sustained remission rates and lowered cumulative glucocorticoid exposure compared to placebo. The discussion also covers clinical implications, safety signals such as neutropenia and arthralgia, and how this biologic therapy may shape future treatment paradigms for difficult-to-treat PMR. Tune in to better understand how sarilumab offers a targeted alternative for patients with limited treatment options beyond steroids.