Toru Mima1, Norihiro Nishimoto. 1. Laboratory of Immune Regulation, Wakayama Medical University, Wakayama City, Wakayama, Japan.
Abstract
PURPOSE OF REVIEW: Interleukin-6 (IL-6) is a multifunctional cytokine that regulates inflammatory response and immune reaction. Overproduction of IL-6 is pathologically involved in inflammatory autoimmune diseases such as rheumatoid arthritis (RA) and juvenile idiopathic arthritis, and therefore, blocking IL-6 activity is one of therapeutic options for these diseases. Tocilizumab is a humanized anti-IL-6 receptor (IL-6R) antibody and inhibits IL-6 activity. There is now accumulating evidence that tocilizumab is therapeutically effective for patients with RA and other inflammatory autoimmune diseases. This article reviews the clinical value of blocking IL-6R. RECENT FINDINGS: Tocilizumab, as monotherapy and in combination with methotrexate, has been shown to be effective for RA patients with insufficient efficacy to methotrexate or other disease-modifying antirheumatic drugs. These findings of tocilizumab have been expanded to patients refractory to tumor necrosis factor inhibitors. Tocilizumab also retards the progression of structural joint damage. Furthermore, a 5-year long-term safety and efficacy has been shown. Tocilizumab is also a promising therapeutic option for other rheumatic diseases such as systemic-onset juvenile idiopathic arthritis, adult-onset Still's disease, and Takayasu arteritis. SUMMARY: Blocking IL-6R with tocilizumab represents a promising new treatment for RA and other inflammatory diseases. Large registry data will warrant the safety profile of tocilizumab.
PURPOSE OF REVIEW: Interleukin-6 (IL-6) is a multifunctional cytokine that regulates inflammatory response and immune reaction. Overproduction of IL-6 is pathologically involved in inflammatory autoimmune diseases such as rheumatoid arthritis (RA) and juvenile idiopathic arthritis, and therefore, blocking IL-6 activity is one of therapeutic options for these diseases. Tocilizumab is a humanized anti-IL-6 receptor (IL-6R) antibody and inhibits IL-6 activity. There is now accumulating evidence that tocilizumab is therapeutically effective for patients with RA and other inflammatory autoimmune diseases. This article reviews the clinical value of blocking IL-6R. RECENT FINDINGS:Tocilizumab, as monotherapy and in combination with methotrexate, has been shown to be effective for RApatients with insufficient efficacy to methotrexate or other disease-modifying antirheumatic drugs. These findings of tocilizumab have been expanded to patients refractory to tumor necrosis factor inhibitors. Tocilizumab also retards the progression of structural joint damage. Furthermore, a 5-year long-term safety and efficacy has been shown. Tocilizumab is also a promising therapeutic option for other rheumatic diseases such as systemic-onset juvenile idiopathic arthritis, adult-onset Still's disease, and Takayasu arteritis. SUMMARY: Blocking IL-6R with tocilizumab represents a promising new treatment for RA and other inflammatory diseases. Large registry data will warrant the safety profile of tocilizumab.
Authors: Teresa K Tarrant; Peng Liu; Rishi R Rampersad; Denise Esserman; Lisa R Rothlein; Roman G Timoshchenko; Marcus W McGinnis; David J Fitzhugh; Dhavalkumar D Patel; Alan M Fong Journal: Arthritis Rheum Date: 2012-05