Blocking the Effects of Interleukin-6 in Rheumatoid Arthritis and Other Inflammatory Rheumatic Diseases: Systematic Literature Review and Meta-analysis Informing a Consensus Statement

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 2012 Nov 13

PMID 23144446

Citations 41

Authors

Monika M Schoels

Desiree van der Heijde

Ferdinand C Breedveld

Gerd R Burmester

Maxime Dougados

Paul Emery

Gianfranco Ferraccioli

Cem Gabay

Allan Gibofsky

Juan Jesus Gomez-Reino

Graeme Jones

Tore K Kvien

Miho Murakami

Miho M Murikama

Norihiro Nishimoto

Josef S Smolen

Affiliations

Soon will be listed here.

Abstract

Background: Suppression of the immunoinflammatory cascade by targeting interleukin 6 (IL-6) mediated effects constitutes a therapeutic option for chronic inflammatory diseases. Tocilizumab is the only IL-6 inhibitor (IL-6i) licensed for rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), but also other agents targeting either IL-6 or its receptor are investigated in various indications.

Objective: To review published evidence on safety and efficacy of IL-6i in inflammatory diseases.

Methods: We performed systematic literature searches in Medline and Cochrane, screened EULAR and American College of Rheumatology meeting-abstracts, and accessed http://www.clinicaltrials.gov.

Results: Comprehensive evidence supports the efficacy of tocilizumab in RA in DMARD-naïve patients, and after DMARD- and TNFi-failure. Randomised comparisons demonstrate superiority of tocilizumab in JIA, but not ankylosing spondylitis (AS). Other indications are currently investigated. Additional IL-6i show similar efficacy; safety generally appears acceptable.

Conclusions: IL-6i is effective and safe in RA and JIA, but not in AS. Preliminary results in other indications need substantiation.

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