Anti-interleukin-6 therapy in rheumatoid arthritis.
Recent advances in research have led to significant progress in unraveling the pathophysiology of rheumatoid arthritis (RA), including the cytokine-mediated signaling process. While therapies targeting one particular cytokine, tumor necrosis factor-alpha (TNF-α), have revolutionized the treatment of RA, other cytokines, including interleukin 6 (IL-6,) have been implicated in the disease process. In this review, we describe the research that ultimately led to large, randomized, controlled trials demonstrating the effectiveness of tocilizumab, a monoclonal antibody directed against the IL-6 receptor, as a potent new therapeutic agent in RA treatment. These data have shown this agent to be effective both in patients failing non-biologic DMARDs and those failing anti-TNF therapy, although the drug is currently approved for use only in the latter situation. Adverse events seen with tocilizumab therapy are also reviewed.
Woodrick
Robert
R
Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. USA.
Ruderman
Eric M
EM
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D000093242:Interleukin-6 Inhibitors; D015850:Interleukin-6
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000093242:Interleukin-6 Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; C502936:tocilizumab