The content of this evidence summary was up to date in January 2021. New evidence may have been published since then. See summaries of product characteristics (SPCs), British national formulary (BNF) or the Medicines and Healthcare products Regulatory Agency (MHRA) or NICE websites for up-to-date prescribing information.
Sarilumab is an interleukin‑6 inhibitor. It has a marketing authorisation for moderate to severe rheumatoid arthritis in adults whose condition has not responded adequately to 1 or more disease modifying antirheumatic drugs. It is licensed for use in combination with methotrexate, or as monotherapy if methotrexate is inappropriate or not tolerated (see the summaries of product characteristics for sarilumab). Use of sarilumab for COVID‑19 is off label.
This evidence summary includes 1 prepublication study only, with a small number of patients randomised to sarilumab (n=48). This means that the findings may change if further evidence becomes available.
Preliminary evidence from the REMAP‑CAP study has suggested that sarilumab is beneficial in adults with severe COVID‑19 who are critically ill and receiving respiratory or cardiovascular organ support in an intensive care setting. Sarilumab was given within about 24 hours of starting organ support.
It is possible that any benefit from sarilumab is seen only in the most severely ill patients given sarilumab soon after organ support is started, when any developing organ dysfunction may be more reversible.
NICE has also published a related COVID-19 rapid evidence summary on tocilizumab for COVID-19.