Sarilumab increases remission, decreases steroid dose in polymyalgia rheumatica taper, but at a high cost (SAPHYR)

Does the monoclonal antibody sarilumab facilitate the tapering of glucocorticoid therapy in patients with polymyalgia rheumatica?

Giving patients with PMR sarilumab twice monthly for 1 year allows an accelerated tapering regimen that greatly reduces the cumulative steroid dose and increases the likelihood of remission (which was low in both groups). Neutropenia, diarrhea, and arthralgia were common adverse effects. The annual drug cost is estimated to be $18,400. The cost per additional sustained response is more than $90,000, and it is unclear what the value is of the lower cumulative dose of prednisone.