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.
Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. USA.
Robert
R
Woodrick
Eric M
EM
Ruderman
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