From the Guidelines
There is no known significant interaction between Ajovy (fremanezumab) and Kevzara (sarilumab), so these medications can generally be taken together. Ajovy is a monoclonal antibody that targets calcitonin gene-related peptide (CGRP) and is used for migraine prevention, while Kevzara is an interleukin-6 (IL-6) receptor antagonist used to treat rheumatoid arthritis, as discussed in the 2019 update of the EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs 1. These medications work through different mechanisms and target different pathways in the body.
Key Considerations
- Ajovy is typically administered as a monthly 225 mg subcutaneous injection or as a quarterly 675 mg dose.
- Kevzara is usually given as a 200 mg subcutaneous injection every two weeks, and its use is guided by recommendations such as those from the EULAR, which suggest that biological DMARDs like Kevzara should be combined with a conventional synthetic DMARD, unless the patient cannot use these as comedication 1.
- Both are injectable medications, so it's crucial to follow proper injection technique and rotation of injection sites to minimize the risk of adverse effects.
- As with any medication combination, it's essential to inform all healthcare providers about all medications being taken, including Ajovy and Kevzara, to ensure comprehensive care and monitoring for potential interactions or side effects.
Monitoring and Adjustments
Given that rheumatoid arthritis is a lifelong disease that requires ongoing management, as highlighted by Smolen et al. in their discussion on the EULAR recommendations 1, patients on Kevzara and other disease-modifying antirheumatic drugs (DMARDs) should be closely monitored. This includes frequent assessments of disease activity and adjustments to the treatment strategy as needed, potentially involving the switch to or addition of other medications if the treatment target is not achieved. However, the decision to use Ajovy concurrently with Kevzara should be based on the individual patient's needs and medical history, considering the potential benefits and risks of combining these medications.
From the Research
Interaction between Ajovy (Fremanezumab) and Kevzara (Sarilumab)
There is limited information available on the interaction between Ajovy (Fremanezumab) and Kevzara (Sarilumab).
- The provided studies focus on the efficacy and safety of Fremanezumab in the treatment of migraines 2, 3, 4, 5.
- One study suggests that Calcitonin gene-related peptide (CGRP) monoclonal antibodies, such as Fremanezumab, may trigger inflammatory flares in patients with autoimmune diseases, including rheumatoid arthritis 6.
- However, there is no direct evidence on the interaction between Ajovy (Fremanezumab) and Kevzara (Sarilumab), which is used to treat rheumatoid arthritis.
- Further research is necessary to understand the potential interaction between these two medications and to determine the safety and efficacy of their combined use 6.
Key Points
- Fremanezumab is a CGRP monoclonal antibody used for the preventive treatment of migraines 2, 3, 4, 5.
- Kevzara (Sarilumab) is an interleukin-6 receptor antagonist used to treat rheumatoid arthritis.
- There is limited information available on the interaction between Ajovy (Fremanezumab) and Kevzara (Sarilumab).
- Further research is necessary to understand the potential interaction between these two medications and to determine the safety and efficacy of their combined use 6.