Tapering while on Kevzara?

[Khof123]

Any tips for tapering while on Kevzara? Any hints on knowing when to decrease prednisone and by how much?

Thanks!

[PMRpro Ambassador]

When I started tocilizumab for PMR, which basically does the same thing but with a different mechanism, my rheumy said not to start for at least a month or so, let the drug build up its effect, and then taper as I felt comfortable. I reduced 1mg at a time, about 2-3 weeks between drops and had no problems. Below 10 I went a bit slower - and stopped a couple of times before going on. When I attempted to go below 7mg I went even slower because that is about when you hope adrenal function will start to wake up if you have been on pred for a long time.

But if I go below 7mg I develop excruciating bicep tendinitis as part of my PMR so I can't last long on 6mg or less. Like TCZ, Kevzara only works on one of the possible mechanisms that creates inflammation in PMR and if your PMR involves the others, you continue to need pred to manage them and you may not get to zero.

[Khof123 in reply to PMRpro]

Thank you!

[Darkchocolate1]

I took Kevzara for PMR for 4 months and never felt better. I tapered from 10 mg to 7 mg. The taper was easy. I quit due to skin issues and several surgeries. A year later I am still at 7 mg and can’t get down to 6 1/2 mg. Tried twice. I recommend it if you can get along without side effects. Seemed like a miracle to me.

[Khof123 in reply to Darkchocolate1]

I'm sorry to hear you had to get off Kevzara if it worked so well for you! Do they have any other options other than prednisone?

[PMRpro Ambassador in reply to Khof123]

The only options for PMR currently are corticosteroids: prednisone, prednisolone and methyprednisolone. The role of other medications is only as steroid-sparers - in some people the DMARDs can reduce the amount of pred required, the biologics, tocilizumab and Kevzara, are also only steroid sparers although for half of patients they can replace pred entirely. For half they only reduce the pred required as other mechanisms besides IL-6 are involved and the biologics only work in IL-6 mediated inflammation. None of the actually influence the disease process - they only deal with inflammation.

[Darkchocolate1 in reply to Khof123]

No other options just other steroid soarers. I tried two others and could not take them either due to side effects. I will just keep trying to taper very slowly on my own. Will try when it is warmer weather and my osteo arthritis isn’t as severe.

[Khof123 in reply to Darkchocolate1]

What type of skin issues did you have on Kevzara?

[Darkchocolate1 in reply to Khof123]

I had peeling and flaking skin all over and several skin cancers. After 3 surgeries no more skin cancer currently and my skin stopped peeling. I really wish I could take it as I felt great while on it.