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Abstract Number: 2243

Patient Reported Outcomes from a Randomized Phase 3 Trial of Sarilumab in Polymyalgia Rheumatica

Vibeke Strand1, Jennifer Sloane Lazar2, Michael C Nivens3, Jingdong Chao4, Stefano Fiore5, Angeliki Giannelou6, Lita Araujo7 and Jerome Msihid8, 1Stanford University School of Medicine, Stanford, CA, 2Sanofi, Delray Beach, FL, 3Regeneron Pharmaceuticals, Inc., Tarrytown, NY, NY, 4Regeneron Pharmaceuticals, Inc.,, Tarrytown, NY, 5Sanofi, Bridgewater, NJ, 6Regeneron Pharmaceuticals, Inc., Hoboken, NJ, 7Sanofi, Cambridge, MA, 8Sanofi, Chilly-Mazarin, France

Meeting: ACR Convergence 2022

Keywords: Health Assessment Questionnaire (HAQ), Miscellaneous Rheumatic and Inflammatory Diseases, Patient reported outcomes, Randomized Trial, SF36

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Session Information

Date: Monday, November 14, 2022

Session Title: Abstracts: Patient Outcomes, Preferences, and Attitudes: Patient Priorities and Preferences: Interventions and Transformation

Session Type: Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease in the elderly. The phase 3 SAPHYR trial (NCT03600818) assessed the efficacy and safety of sarilumab, a fully human monoclonal antibody directed against sIL-6Rα, for treatment of relapsing PMR. The primary endpoint, sustained remission at week (wk) 52, was met by sarilumab treatment with rapid glucocorticoid (GC) tapering and less total GC doses (p = 0.0193).1 This analysis assessed its effects on patient reported outcomes (PROs).

Methods: This phase 3 randomized placebo-controlled trial enrolled 118 patients of the intended 280 as the study was prematurely terminated due to protracted recruitment timelines exacerbated by the COVID-19 pandemic. Patients were randomized to receive either sarilumab with a GC tapering regimen over 14 wks (n = 60), or placebo with 52 wk GC taper (n = 58). PROs (Patient Global Assessment of disease activity [PtGA], pain visual analog scale [VAS], Health Assessment Questionnaire Disability Index [HAQ-DI], Functional Assessment of Chronic Illness Therapy–Fatigue [FACIT-F], Short Form Health Survey version 2 [SF-36 v2], and EuroQoL 5-Dimension 3-Level [EQ-5D-3L]) were assessed at baseline to wk 52. Between-group differences in least-squares mean (LSM) changes from baseline were assessed and proportions of patients reporting improvements ≥ minimal clinically important differences (MCID) and scores ≥ normative values compared between groups. All p-values were nominal.

Results: At wk 52, sarilumab treatment resulted in statistically significantly greater improvements from baseline than comparator arm in SF-36 Physical (PCS: p = 0.0172) and Mental (MCS: p = 0.0295) Component Summary scores and 5 of 8 domains (Table 1 & Figure 1). Sarilumab treatment also led to significantly greater improvements from baseline in EQ-5D-3L utility index score (p = 0.0336) and numerically greater improvements in EQ VAS, FACIT-F, HAQ-DI, PtGA, and pain scores (Table 1). Post-hoc analyses demonstrated that more patients treated with sarilumab reported improvements ≥ MCID in SF-36 PCS (p = 0.0161) score (Table 2), resulting in number needed to treat of 3.7. Numerically, there were more sarilumab responder patients across all PROs with exception of SF-36 mental health domain and Pain VAS (Table 2). Numerically more patients receiving sarilumab also reported scores ≥ US age/gender matched normative values in SF-36 MCS and 4 domains, HAQ-DI, and FACIT-F at week 52 (data not shown).

Conclusion: Consistent with the primary endpoint, PROs demonstrated clinically meaningful and robust improvements in health-related quality of life for relapsing PMR patients treated with sarilumab. Sarilumab has not been approved for the treatment of PMR in any jurisdiction.

Reference
1Dasgupta B: LB0006, ARD 2022; 81 Supp 1: p210-11

Supporting image 1

Table 1: Effect of Sarilumab vs Placebo on PROs at Week 52

Supporting image 2

Figure 1: Mean SF_36 Domain Scores at Baseline and Week 52

Supporting image 3

Table 2: Patients Reporting Improvements ≥MCID at Week 52


Disclosures: V. Strand, AbbVie, Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb(BMS), Boehringer-Ingelheim, Chemocentryx, Celltrion, Genentech/Roche, Gilead, GlaxoSmithKlein(GSK), Inmedix, Janssen, Kiniksa, Merck/MSD, Novartis, Pfizer, Regeneron Pharmaceuticals, Rheos, R-Pharma, Samsung, Sandoz, Sanofi, Scipher, Setpoint, Spherix, Aria, Bioventus, Blackrock, Equilium, Glenmark, Horizon, Kypha, Lilly, MiMedx, Sorrento, Tonix, Priovant; J. Sloane Lazar, Sanofi; M. Nivens, Regeneron; J. Chao, Regeneron; S. Fiore, Sanofi; A. Giannelou, Regeneron; L. Araujo, Sanofi; J. Msihid, Sanofi.

To cite this abstract in AMA style:

Strand V, Sloane Lazar J, Nivens M, Chao J, Fiore S, Giannelou A, Araujo L, Msihid J. Patient Reported Outcomes from a Randomized Phase 3 Trial of Sarilumab in Polymyalgia Rheumatica [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/patient-reported-outcomes-from-a-randomized-phase-3-trial-of-sarilumab-in-polymyalgia-rheumatica/. Accessed May 30, 2023.
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