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Aletaha, D.; Kerschbaumer, A.; Kastrati, K.; Dejaco, C.; Dougados, M.; McInnes, I.B.; ... ; Smolen, J.S. (2022)

Consensus statement on blocking interleukin-6 receptor and interleukin-6 in inflammatory conditions: an update

Article / Letter to editor
Background: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6R alpha antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, based on most recent evidence and expert opinion, that aims to inform on the medical use of interfering with the IL-6 pathway. Methods: A systematic literature research was performed that focused on IL-6-pathway inhibitors in inflammatory diseases. Evidence was put in context by a large group of international experts and patients in a subsequent consensus process. All were involved in formulating the consensus statements, and in the preparation of this document. Results: The consensus process covered relevant aspects of dosing and populations for different indications of IL-6 pathway inhibitors that are approved across the world,...Show moreBackground: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6R alpha antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, based on most recent evidence and expert opinion, that aims to inform on the medical use of interfering with the IL-6 pathway. Methods: A systematic literature research was performed that focused on IL-6-pathway inhibitors in inflammatory diseases. Evidence was put in context by a large group of international experts and patients in a subsequent consensus process. All were involved in formulating the consensus statements, and in the preparation of this document. Results: The consensus process covered relevant aspects of dosing and populations for different indications of IL-6 pathway inhibitors that are approved across the world, including rheumatoid arthritis, polyarticular-course and systemic juvenile idiopathic arthritis, giant cell arteritis, Takayasu arteritis, adult-onset Still's disease, Castleman's disease, chimeric antigen receptor-T-cell-induced cytokine release syndrome, neuromyelitis optica spectrum disorder and severe COVID-19. Also addressed were other clinical aspects of the use of IL-6 pathway inhibitors, including pretreatment screening, safety, contraindications and monitoring. Conclusions: The document provides a comprehensive consensus on the use of IL-6 inhibition to treat inflammatory disorders to inform healthcare professionals (including researchers), patients, administrators and payers.Show less
rheumatoid arthritis
biological therapy
autoimmune diseases
All authors
Aletaha, D.; Kerschbaumer, A.; Kastrati, K.; Dejaco, C.; Dougados, M.; McInnes, I.B.; Sattar, N.; Stamm, T.A.; Takeuchi, T.; Trauner, M.; Heijde, D. van der; Voshaar, M.; Winthrop, K.L.; Ravelli, A.; Betteridge, N.; Burmester, G.R.R.; Bijlsma, J.W.J.; Bykerk, V.; Caporali, R.; Choy, E.H.; Codreanu, C.; Combe, B.; Crow, M.K.; Wit, M. de; Emery, P.; Fleischmann, R.M.; Gabay, C.; Hetland, M.L.; Hyrich, K.L.; Iagnocco, A.; Isaacs, J.D.; Kremer, J.M.; Mariette, X.; Merkel, P.; Mysler, E.F.; Nash, P.; Nurmohamed, M.T.; Pavelka, K.; Poor, G.; Rubbert-Roth, A.; Schulze-Koops, H.; Strangfeld, A.; Tanaka, Y.; Smolen, J.S.
Date
2022-08-11
Journal
Annals of the Rheumatic Diseases
DOI
doi:10.1136/ard-2022-222784