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Telemedicine tips: I’m thinking about KEVZARA

Get tips on how to prepare for a telemedicine appointment with your doctor.

TRANSCRIPT

VO:
I’m Dr Heinlen, a rheumatologist, and I would like to talk to you about telemedicine. Do you think your rheumatoid arthritis treatment isn’t working but you can’t get to the doctor? Telemedicine might be a great option. Though your doctor cannot perform a physical exam, telemedicine allows you to get advice and have a productive conversation with your doctor wherever you are.

SUPER:
Be prepared.

VO:
If you have a telemedicine appointment coming up, here are some tips for you to be prepared.

SUPER:
Before your appointment

SUPER:
Check your tech.

VO:
Make sure you have a device with a camera, a microphone, and an internet connection. Ask your doctor’s office if there’s an app you need to download for your appointment.

SUPER:
Know the signs.
- morning stiffness
- joint pain and swelling
- reduced ability to move

VO:
Think about the important signs of RA, and if they’re improving on your current treatment.

SUPER:
CRP test

VO:
You might need a blood test the next time you visit your doctor’s office. It might include a C-reactive protein, or CRP, if your joint pain, swelling, and stiffness are getting worse. You may want to ask your doctor to send your bloodwork to a lab near you for faster results.

SUPER:
Be specific.

VO:
Be specific about your symptoms. For example, let your doctor know if your wrist hurts when you open a jar.

SUPER:
See the doctor discussion guide.

VO:
See the doctor discussion guide at the link below this video.

SUPER:
During your appointment

SUPER:
Find a quiet place

VO:
Find a private place to talk. You can use the discussion guide to make sure you cover all of the important points. And make sure to take notes.

SUPER:
Explore your options

VO:
There are different ways to treat RA. If your symptoms aren’t improving, ask your doctor if another option might be appropriate for you.

SUPER:
Get all the answers.

VO:
Make sure you understand everything your doctor said before the appointment ends. If you do run out of time, you can call back to make sure you have everything.

SUPER:
After your appointment

VO:
Jot down all the important points your doctor told you before you forget…

SUPER:
Reflect on your experience.

VO:
…and any parts of your experience that went well, and which parts didn’t. Bring them up with your doctor to make future telemedicine appointments go more smoothly.

CTA:
Get helpful tips at the link below this video.

VO:
And remember, you can get helpful tips when you download the doctor discussion guide at the link below this video.

SUPER:
Download the doctor discussion guide at the link below.

How KEVZARA works

Watch and learn more about the way IL-6 contributes to your RA and how KEVZARA works to control it.

Have you recently been diagnosed with rheumatoid arthritis (RA), an inflammatory rheumatic disease?

Rheumatoid arthritis can cause your immune system to attack your joints, muscles, and bones. Living with RA can take a toll on you, both physically and emotionally.

RA-related joint pain and stiffness can make daily activities that were once easy more difficult. We’re going to explore how proteins like interleukin 6, or IL-6, contribute to your joint pain, swelling, and stiffness, and how IL-6 blockers may help.

IL-6 is a protein in the body that plays a major role in joint pain, swelling, stiffness, and fatigue.

With RA, your body thinks it’s under attack. Your body sends many types of inflammatory proteins to your joints to fight this attack. But it doesn’t know when to stop.

When your body sends too many inflammatory proteins to your joints over a long period of time, these proteins may cause damage to your joints. IL-6 is one of these inflammatory proteins.

Persistently high levels of IL-6 may cause inflammation. The extra inflammatory proteins may cause serious damage to your body over time. Without treatment, RA may permanently damage your joints.

Persistently high levels of IL-6 can affect everyday activities and may make mornings especially tough for those living with RA. Experts believe levels of IL-6 are higher in the morning due to our body’s circadian rhythm, the 24-hour internal cycle that controls essential functions like sleep, eating, and hormone production.

People with RA may experience pain and stiffness in the smaller joints of the body, including the hands, wrists, and knees.

For a cell to respond to IL-6, the IL-6 molecule must attach to an IL-6 receptor. Once attached to the receptor, IL-6 triggers inflammation in the joint. This inflammation can get so bad that it can damage the connective tissue and bone within the joint. Treatments can help protect against this damage or slow it down by blocking IL-6 from reaching its receptor.

How KEVZARA® (sarilumab) blocks IL-6.

What is KEVZARA?

KEVZARA® (sarilumab) is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat adult patients with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.

IMPORTANT SAFETY INFORMATION.

KEVZARA can cause SERIOUS SIDE EFFECTS including:

SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.

Please see additional Important Safety Information at the end of this video.

Blocking persistently high levels of IL-6 may help reduce inflammation, alleviate your symptoms, and let you get back to enjoying the things you love.

Using soccer to show how this works, imagine that the ball is an IL-6 protein, the goal is an IL-6 receptor, and the goalie is something called an IL-6 blocker. To trigger inflammation, the IL-6 protein, or soccer ball, must reach its receptor, or the goal line. To prevent this inflammation, the protein must be blocked. Like a goalie in soccer, an IL-6 blocker prevents it from reaching the goal line.

By preventing IL-6 connections on the cells and in the bloodstream, IL-6 blockers may help relieve pain, reduce joint stiffness and swelling, and slow the progression of joint damage. One of these IL-6 blockers is a treatment called KEVZARA® (sarilumab).

Please see additional Important Safety Information throughout this video and link above for full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide.

Thank you for watching.

[Text on screen]

What is KEVZARA?

KEVZARA® (sarilumab) is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat adult patients with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.

IMPORTANT SAFETY INFORMATION

KEVZARA can cause serious side effects including:

SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.
Before starting KEVZARA, tell your healthcare provider if you
- think you have an infection or have signs or symptoms of an infection, with or without a fever such as sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections.
- have diabetes, HIV, or a weakened immune system.
- have TB, or have been in close contact with someone with TB.
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis).
- have or have had hepatitis.
After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
Do not use KEVZARA if you are allergic to sarilumab or any of the ingredients of KEVZARA.
Before using KEVZARA, tell your healthcare provider if you
- have an infection.
- have liver problems.
- have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines.
- recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines.
  - All vaccines should be brought up-to-date before starting KEVZARA, unless urgent treatment initiation is required.
- plan to have surgery or a medical procedure.
- are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby.
- are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk.
- take prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you use:
  - any other medicines to treat your RA. Using KEVZARA with these medicines may increase your risk of infection.
  - medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
The most common side effects include:
- injection site redness
- injection site itching
- upper respiratory tract infection
- urinary tract infection
- nasal congestion, sore throat, and runny nose

These are not all the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found below or by calling 1-844-KEVZARA.

Please see additional Important Safety Information throughout this video and link above for full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide.

Shirley’s story

Hear how KEVZARA gave Shirley hope in managing her RA.

What is KEVZARA?

KEVZARA® (sarilumab) is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.

IMPORTANT SAFETY INFORMATION.

KEVZARA can cause SERIOUS SIDE EFFECTS including:

SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.

Please see additional Important Safety Information at the end of this video.

TRANSCRIPT

Shirley:

I was working as an executive with a pretty fast-paced life. A lot of travel, working in the field, basically on the go.

In addition to that, I really enjoyed biking, golfing, walking.

And then, my life completely changed.

I was actually on a business trip. I had no idea what was going on. In the middle of the flight I got this severe, awful pain in my hip. It feels like you’ve been in a major car accident. I was quite alarmed and confused and scared.

Ten days later I was using a cane to walk, and then shortly after that, a walker, a scooter, a wheelchair.

My name is Shirley, and I have rheumatoid arthritis for 14 years now.

Rheumatoid arthritis doesn’t just affect your joints. You’re not just tired. Debilitation is not all of it. It affects your whole body. Because people can’t really see what’s happening underneath the skin, they tend to be very dismissive. So the reality is you’ve lost total confidence in what you can do.

You become more and more isolated and you don’t want to be around a lot of people. Feeling tired is more pronounced early in the mornings. You take longer to do everything. I remember just standing in the shower sometimes for 20, 30 minutes just trying to move around.

I used to love to sew. Well I couldn’t do that anymore as I was suffering with this disease. I couldn’t use scissors, my fingers were starting to get more tender, so I couldn’t hold a needle, definitely couldn’t thread.

For the 14 years, I’ve been on multiple therapies, some of them worked for a while, and then I started to fall off. I was actively looking, calling, searching the internet trying to see if there was a new product that people were talking about.

I heard about KEVZARA. I contacted my physician. Two days later, I got the script, and I started.

[Text on screen]

Individual results may vary.

Shirley:

With KEVZARA, I’ve noticed I could do a lot of the things that I didn’t think I would ever be able to do again.

I get going a lot sooner, get out of bed, you know, starting my day. Putting on makeup now is a lot easier which, that’s one of my favorite things to do, because I can now unscrew the tops, I can hold things without having the fear of dropping them.

I’ve been able to start biking again, dance again, which is all a part of me feeling that confidence that I wanted to have again. Just think about how you feel with that kind of accomplishment.

KEVZARA has given me hope. This is how far I’ve come. And this is not where I’m going to stop.

Kudos to me, right?

IMPORTANT SAFETY INFORMATION (CONTINUED)

Before starting KEVZARA, tell your healthcare provider if you
- think you have an infection or have symptoms of an infection, with or without a fever. Symptoms may include sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections
- have diabetes, HIV, or a weakened immune system
- have TB, or have been in close contact with someone with TB
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis)
- have or have had hepatitis
After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
Do not use KEVZARA if you are allergic to sarilumab or any of the ingredients of KEVZARA.
Before using KEVZARA, tell your healthcare provider if you
- have an infection
- have liver problems
- have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines
- recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines
- plan to have surgery or a medical procedure
- are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby
- are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk.
- take prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you use
  - any other medicines to treat your RA. Using KEVZARA with these medicines may increase your risk of infection.
  - medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
The most common side effects include:
- injection site redness
- injection site itching
- upper respiratory tract infection
- urinary tract infection
- nasal congestion, sore throat, and runny nose

These are not all of the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found below or by calling 1-844-KEVZARA.

Please see Important Safety Information below, including risk of SERIOUS SIDE EFFECTS, and full Prescribing Information and Medication Guide on this website.

How to use the pre-filled pen

Watch for step-by-step instructions on how to use the pre-filled pen.

How to Inject KEVZARA® (sarilumab) Using the Pre-filled Pen

What is KEVZARA?
KEVZARA® (sarilumab) is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat adult patients with:

moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.
polymyalgia rheumatica (PMR) after corticosteroids have been used and did not work well or when a slow decrease in the dose of corticosteroids (taper) cannot be tolerated.

IMPORTANT SAFETY INFORMATION
KEVZARA can cause SERIOUS SIDE EFFECTS including:

SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.

Please see additional Important Safety Information throughout this video and full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

Starting a new treatment can be a little overwhelming. Don’t worry, we’re here to help! We’ll walk you through the instructions step by step so you can get more comfortable injecting with the KEVZARA pre-filled pen. With time, it will become part of your routine. You can even set your phone to remind you when it’s time to take KEVZARA.

Before getting started, make sure to read all of the instructions, including the Medication Guide and Instructions for Use, that are in your KEVZARA package.

Watch this entire video to get more familiar with each step and read the Important Safety Information at the end. You can always refer back to the instructions in this video whenever you need.

If your doctor decides you or your caregiver can give KEVZARA at home, they’ll show you how to do it the right way. Don’t try to inject KEVZARA until you’ve been properly trained. You can also ask your doctor if you have questions at any time.

KEVZARA is given as an injection under the skin once every two weeks. You should use the dose prescribed to you by your doctor. The steps for injecting with the pre-filled pen are the same, no matter which dose your doctor prescribed.

Here are a few things to remember: You should store the KEVZARA pre-filled pen inside its original carton in your refrigerator between 36 degrees Fahrenheit and 46 degrees Fahrenheit until you’re ready to use it. Keep the pre-filled pen out of the reach of children.

Do not freeze, heat up, shake, or expose the pre-filled pen to direct sunlight.

Once you take the pre-filled pen out of the refrigerator, it can be stored at room temperature up to 77 degrees Fahrenheit for up to 14 days in the original packaging. Throw away the pre-filled pen if it has been kept at room temperature and was not used within 14 days. Keep KEVZARA and all medicines out of the reach of children.

Don’t use the pre-filled pen if it’s damaged or the orange cap is missing or not attached. If it is, return the unused pen and the package it came in to your pharmacy. Don’t ever reuse the pre-filled pen and don’t try to inject KEVZARA through your clothes.

Now, let’s go through the instructions for injecting. You can use the Instructions for Use that came with your prescription to follow along.

Before you get started, prepare everything you need on a clean, flat surface. You’ll need an unused KEVZARA pre-filled pen. You’ll also need an alcohol wipe, a cotton ball or gauze, and a sharps disposal container.

Take one of your pens out of the packaging by holding the middle of the pen body. Don’t remove the orange cap until you are ready to inject. If you have another pen left in the package, put it back in the refrigerator now.

Look at the label and check to see that you have the right dose. Also, check the expiration date. You will see this labeled on the side of the pen. If the expiration date has passed, don’t use it. Throw it away in your sharps container and use a new one.

Next, take a look at the window of the pre-filled pen. If the liquid in the window is clear and colorless to pale yellow, you’re good to go. You may see air bubbles, but this is normal.

However, if the liquid in the window is cloudy, discolored or contains particles, or if the window is solid yellow, don’t use it. Throw it away in your sharps container and get a new one.

Now, you’ll need to lay the pen on a flat surface and let it warm up to room temperature. This should take at least 60 minutes. Using the pen at room temperature may help make the injection more comfortable. Don’t try to warm the pen in any other way. Let it warm up naturally. Don’t use the pen if it’s been out of the refrigerator for more than 14 days.

The next step is choosing where to inject. You can inject into your thigh or belly. Try not to get too close to your belly button by staying more than 2 inches, or 5 centimeters, away from your belly button.

If someone else is giving you the injection, they can use the outer area of your upper arm.

Be sure to change the injection site each time you inject, and don’t inject into skin that is tender, damaged, or has bruises or scars.

The last step before injecting is preparing your injection site. Make sure you wash your hands with soap and water before you do this.

After washing your hands, use an alcohol wipe to clean the skin at the injection site really well and then let it air dry. Don’t touch the injection site again before the injection.

Now you’re ready to give the injection. You should only perform this part after completing all the steps in the “Get ready for your injection” section.

You will start by twisting or pulling off the orange cap. Don’t touch the yellow needle cover and don’t put the orange cap back on.

Next, you will put the yellow needle cover on your skin at about a 90-degree angle. Make sure you can see the window.

Press down and hold the pen firmly against your skin. There will be a click when the injection starts.

Keep holding the pen firmly against your skin. You will see the window starting to turn solid yellow. The injection can take up to 15 seconds.

You will hear a second click when the injection is complete. Check to see that the entire window has turned solid yellow before you remove the pen. If you do not hear the second click, you should still check to see if the entire window has turned solid yellow.

If the entire window does not turn solid yellow, this could mean that you may not have received your full dose of medicine. If this happens, call your doctor right away.

Now, you can remove the pen from your skin. The needle will be covered automatically after you remove the pen from your skin.

You might see a little bleeding at the injection site. Don’t worry, just press a cotton ball or gauze over the site until the bleeding stops, but don’t rub it.

Throw away the pen in a sharps disposal container right after you finish using it. Don’t throw the pen out in your household trash or put the orange cap back on, and please do not reuse it.

If you don’t have an FDA-cleared sharps disposal container, you may use a puncture-resistant container that is made of a heavy-duty plastic that can be closed with a tight-fitting, puncture-resistant lid, to prevent the sharps from being able to come out.

The container should be upright and stable during use, leak-resistant, and properly labeled to warn people that there’s hazardous waste inside.

Also, don’t recycle your used sharps container or throw your used sharps container in the trash unless your community guidelines permit it. You can find more information about safely disposing used sharps containers, including specific information about sharps disposal in the state you live in, by visiting the FDA website at www.fda.gov/safesharpsdisposal.

Remember to always keep the sharps disposal container and the KEVZARA pre-filled pen out of the reach of children.

If you have any questions or concerns about your medication or your disease, always call your doctor. Please continue watching for additional Important Safety Information and see the full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

IMPORTANT SAFETY INFORMATION (CONTINUED)

Before starting KEVZARA, tell your healthcare provider if you
- think you have an infection or have signs or symptoms of an infection, with or without a fever such as sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections.
- have diabetes, HIV, or a weakened immune system.
- have TB, or have been in close contact with someone with TB.
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis).
- have or have had hepatitis.
After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
Do not use KEVZARA if you are allergic to sarilumab or any of the ingredients of KEVZARA.
Before using KEVZARA, tell your healthcare provider if you
- have an infection.
- have liver problems.
- have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines.
- recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines.
  - All vaccines should be brought up-to-date before starting KEVZARA, unless urgent treatment initiation is required.
- plan to have surgery or a medical procedure.
- are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby.
- are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk.
- take prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you use:
  - any other medicines to treat your RA or PMR. Using KEVZARA with these medicines may increase your risk of infection.
  - medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
The most common side effects include:
- injection site redness
- injection site itching
- upper respiratory tract infection
- urinary tract infection
- nasal congestion, sore throat, and runny nose

These are not all the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found at www.KEVZARA.com or by calling 1-844-KEVZARA.

Please see full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

There you have it! We hope this video was helpful for you as you get comfortable with injecting using the KEVZARA pre-filled pen.

Should you ever need to refresh your memory, you can re-watch this video at any time. You can also find the step-by-step instructions at www.KEVZARA.com.

How to use the pre-filled syringe

Watch for step-by-step instructions on how to use the pre-filled syringe.

How to Inject KEVZARA® (sarilumab) Using the Pre-filled Syringe

What is KEVZARA?
KEVZARA® (sarilumab) is an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker. KEVZARA is used to treat:

adult patients with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a disease-modifying antirheumatic drug (DMARD) has been used and did not work well or could not be tolerated.
adult patients with polymyalgia rheumatica (PMR) after corticosteroids have been used and did not work well or when a slow decrease in the dose of corticosteroids (taper) cannot be tolerated.
people with active polyarticular juvenile idiopathic arthritis (pJIA) who weigh 63kg (139 lbs) or more.

It is not known if KEVZARA is safe and effective in children with pJIA under 2 years of age.

IMPORTANT SAFETY INFORMATION
KEVZARA can cause SERIOUS SIDE EFFECTS including:

SERIOUS INFECTIONS. KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you or your child for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.

Please see additional Important Safety Information throughout this video and full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

Starting a new treatment can be a little overwhelming. Don’t worry, we’re here to help! We’ll walk you through the instructions step by step so you can get more comfortable injecting with the KEVZARA pre-filled syringe. With time, it will become part of your routine. You can even set your phone to remind you when it’s time to take KEVZARA.

Before getting started, make sure to read all of the instructions, including the Medication Guide and Instructions for Use, that are in your KEVZARA package.

Watch this entire video to get more familiar with each step and read the Important Safety Information at the end. You can always refer back to the instructions in this video whenever you need.

If your doctor decides you or your caregiver can give KEVZARA at home, they’ll show you how to do it the right way. Don’t try to inject KEVZARA until you’ve been properly trained. You can also ask your doctor if you have questions at any time.

KEVZARA is given as an injection under the skin once every two weeks. You should use the dose prescribed to you by your doctor. The steps for injecting with the pre-filled syringe are the same, no matter which dose your doctor prescribed.

Here are a few things to remember: You should store the KEVZARA pre-filled syringe inside its original carton in your refrigerator between 36 degrees Fahrenheit and 46 degrees Fahrenheit until you’re ready to use it. Keep the pre-filled syringe out of the reach of children.

Do not freeze, heat up, shake, or expose the pre-filled syringe to direct sunlight.

Once you take the pre-filled syringe out of the refrigerator, it can be stored at room temperature up to 77 degrees Fahrenheit for up to 14 days in the original packaging. Throw away the pre-filled syringe if it has been kept at room temperature and was not used within 14 days. Keep KEVZARA and all medicines out of the reach of children.

Don’t use the pre-filled syringe if it is damaged or the needle cap is missing or not attached. If it is, return the unused syringe and the package it came in to your pharmacy. Don’t ever reuse the pre-filled syringe and don’t try to inject KEVZARA through your clothes.

Now, let’s go through the instructions for injecting. You can use the Instructions for Use that came with your prescription to follow along.

Before you get started, prepare everything you need on a clean, flat surface. You’ll need an unused KEVZARA pre-filled syringe. You’ll also need an alcohol wipe, a cotton ball or gauze, and a sharps disposal container.

Take one of your syringes out of the packaging by holding the middle of the syringe body. Don’t hold the syringe by the plunger, finger grip, or needle cap. Don’t pull off the needle cap until you are ready to inject. If you have another syringe left in the package, put it back in the refrigerator now.

Look at the label and check to see that you have the right dose. Also, check the expiration date. You will see this labeled on the side of the syringe. If the expiration date has passed, don’t use it. Throw it away in your sharps container and get a new one.

Next, take a look at the liquid in the syringe. If the liquid is clear and colorless to pale yellow, you’re good to go. You may see air bubbles, but this is normal.

However, if the liquid is cloudy, discolored, or contains particles, don’t use it. Throw it away in your sharps container and get a new syringe.

Now, you’ll need to lay the syringe on a flat surface and let it warm up to room temperature. This should take at least 30 minutes. Using the syringe at room temperature may help make the injection more comfortable. Don’t try to warm it up in any other way. Let it warm up naturally. Don’t use the syringe if it’s been out of the refrigerator for more than 14 days.

The next step is choosing where to inject. You can inject into your thigh or belly. Try not to get too close to your belly button by staying more than 2 inches, or 5 centimeters, away from your belly button.

If someone else is giving you the injection, they can use the outer area of your upper arm.

Be sure to change the injection site each time you inject, and don’t inject into skin that is tender, damaged, or has bruises or scars.

The last step before injecting is preparing your injection site. Make sure you wash your hands with soap and water before you do this.

After washing your hands, use an alcohol wipe to clean the skin at the injection site really well and then let it air dry. Don’t touch the injection site again before the injection.

Now you’re ready to give the injection. You should only perform this part after completing all the steps in the “Get ready for your injection” section.

First, pull off the needle cap by holding the syringe at the middle of the syringe body with the needle pointing away from you. Don’t remove the needle cap until you are ready to inject. Keep your hands off the plunger. If you notice air bubbles, that’s OK. Don’t try to get rid of any air bubbles in the syringe before injecting.

Next, using your thumb and index finger, pinch a fold of skin at the clean injection site without touching the site itself.

Now, take a deep breath, exhale… and insert the needle into the fold of your skin at about a 45-degree angle.

Slowly push the plunger down as far as it will go until the syringe is empty.

Once the plunger is down, make sure to check that the syringe is empty. Then pull the needle out at the same angle it went in.

You might see a little bleeding at the injection site. Don’t worry, just press a cotton ball or gauze over the site until the bleeding stops, but don’t rub it.

Throw away the syringe in a sharps disposal container right after you finish using it. Don’t throw the syringe out in your household trash or put the needle cap back on, and never reuse a syringe.

If you don’t have an FDA-cleared sharps disposal container, you may use a puncture-resistant container that is made of a heavy-duty plastic that can be closed with a tight-fitting, puncture-resistant lid, to prevent the sharps from being able to come out.

The container should be upright and stable during use, leak-resistant, and properly labeled to warn people that there’s hazardous waste inside.

Also, don’t recycle your used sharps container or throw your used sharps container in the trash unless your community guidelines permit it. You can find more information about safely disposing used sharps containers, including specific information about sharps disposal in the state you live in, by visiting the FDA website at www.fda.gov/safesharpsdisposal.

Remember to always keep the sharps disposal container and the KEVZARA pre-filled syringe out of the reach of children.

If you have any questions or concerns about your medication or your disease, always call your doctor. Please continue watching for additional Important Safety Information and see the full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

IMPORTANT SAFETY INFORMATION (CONTINUED)

Before starting KEVZARA, tell your healthcare provider if you:
- think you have an infection or have signs or symptoms of an infection, with or without a fever such as sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections.
- have diabetes, HIV, or a weakened immune system.
- have TB, or have been in close contact with someone with TB.
- live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis).
- have or have had hepatitis.
After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your or your child’s healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your or your child’s healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you or your child have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
Do not use KEVZARA if you or your child are allergic to sarilumab or any of the ingredients of KEVZARA.
Before you or your child use KEVZARA, tell your healthcare provider if you or your child:
- have an infection.
- have liver problems.
- have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines.
- recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines.
  - All vaccines should be brought up-to-date before starting KEVZARA, unless urgent treatment initiation is required.
- plan to have surgery or a medical procedure.
- are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby.
- are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk.
- take prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you or your child use:
  - any other medicines to treat your RA, PMR, or pJIA. Using KEVZARA with these medicines may increase your risk of infection.
  - medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
The most common side effects include:
- injection site redness
- injection site itching
- upper respiratory tract infection
- urinary tract infection
- nasal congestion, sore throat, and runny nose

These are not all the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found at www.KEVZARA.com or by calling 1-844-KEVZARA.

Please see full Prescribing Information, including risk of SERIOUS SIDE EFFECTS, and Medication Guide on this website.

There you have it! We hope this video was helpful for you as you get comfortable with injecting using the KEVZARA pre-filled syringe.

Should you ever need to refresh your memory, you can re-watch this video at any time. You can also find the step-by-step instructions at www.KEVZARA.com.

Telemedicine tips: I’m taking KEVZARA

TRANSCRIPT

SUPER:
What is telemedicine? Latisha Heinlen, M.D. Rheumatology, Internal Medicine

VO:
I’m Dr. Heinlen, a rheumatologist, and I would like to talk to you about telemedicine. When you need to see your doctor, but you can’t get to the office, you do have options. Telemedicine is one of them. Even though your doctor can’t perform a physical exam, telemedicine lets you get advice and have a more productive conversation, no matter where you are.

SUPER:
Be prepared.

VO:
If you have a telemedicine appointment coming up, here are a few ideas to help you prepare.

SUPER:
Before your appointment

SUPER:
Check your tech.

VO:
Make sure you have a device with a camera, a microphone, and an internet connection.

SUPER:
Know the signs.
- morning stiffness
- joint pain and swelling
- reduced ability to move

VO:
Think about your rheumatoid arthritis. If your symptoms aren’t getting better, be sure to tell your doctor.

If you’re feeling better and want to start new activities, remember to ask your doctor first.

See the doctor discussion guide at the link below this video.

SUPER:
During your appointment

SUPER:
Find a quiet place.

VO:
Look for a private place to talk.

SUPER:
Ask questions.

VO:
Whether you need nutritional advice, have questions about your treatment, or missed a dose, your doctor is there to answer your questions. Don’t be afraid to ask.

SUPER:
Get all the answers.

VO:
Make sure you understand everything your doctor says before your appointment ends. If you run out of time, call back later to make sure you caught everything.

SUPER:
After your appointment

SUPER:
Write it down.

VO:
Jot down anything important that your doctor told you that you might forget…

SUPER:
Reflect on your experience.

VO:
Bring concerns up with your doctor to make future telemedicine appointments go more smoothly.

CTA:
Get helpful tips at the link below this video.

VO:
And remember, you can get helpful tips when you download the doctor discussion guide at the link below this video.

SUPER:
Download the doctor discussion guide at the link below.

Printable RA resources about KEVZARA

RA Patient Brochure

Owning your RA

Video resources about KEVZARA

How to use the pre-filled pen

How to use the pre-filled syringe

How KEVZARA works

Savings and support resources

KevzaraConnect^® Copay Card

Sanofi Patient Connection

Independent copay assistance foundations

Seek support for living with RA

You are now leaving the KEVZARA website.

You are now leaving the KEVZARA website.

You are now leaving the KEVZARA website.

You are now leaving the KEVZARA website.

You are now leaving the KEVZARA website.

You are now leaving the KEVZARA website.

Telemedicine tips: I’m thinking about KEVZARA

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How KEVZARA works

View transcript

Shirley’s story

View transcript

How to use the pre-filled pen

View transcript

How to use the pre-filled syringe

View transcript

Telemedicine tips: I’m taking KEVZARA

View transcript