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Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

Citation

Smolen, JS and Schoels, MM and Nishimoto, N and Breedveld, FC and Burmester, GR and Dougados, M and Emery, P and Ferraccioli, G and Gabay, C and Gibofsky, A and Gomez-Reino, JJ and Jones, G and Kvien, TK and Murakami, M and Betteridge, N and Bingham III, CO and Bykerk, V and Choy, EH and Combe, B and Cutolo, M and Graninger, W and Lanas, A and Martin-Mola, E and Montecucco, C and Ostergaard, M and Pavelka, K and Rubbert-Roth, A and Sattar, N and Scholte-Voshaar, M and Tanaka, Y and Trauner, M and Valentini, G and Winthrop, KL and de Wit, M and van der Heijde, D, Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions, Annals of The Rheumatic Diseases: The Eular Journal, 72, (4) pp. 482-492. ISSN 0003-4967 (2013) [Refereed Article]


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DOI: doi:10.1136/annrheumdis-2012-202469

Abstract

BACKGROUND: Since approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other inflammatory diseases. This consensus document informs on interference with the IL-6 pathway based on evidence and expert opinion. METHODS: Preparation of this document involved international experts in RA treatment and RA patients. A systematic literature search was performed that focused on TCZ and other IL6-pathway inhibitors in RA and other diseases. Subsequently, incorporating available published evidence and expert opinion, the steering committee and a broader expert committee (both including RA patients) formulated the current consensus statement. RESULTS: The consensus statement covers use of TCZ as combination- or monotherapy in various RA populations and includes clinical, functional and structural aspects. The statement also addresses the second approved indication in Europe JIA and non-approved indications. Also early phase trials involving additional agents that target the IL-6 receptor or IL-6 were evaluated. Safety concerns, including haematological, hepatic and metabolic issues as well as infections, are addressed likewise. CONCLUSIONS: The consensus statement identifies points to consider when using TCZ, regarding indications, contraindications, screening, dose, comedication, response evaluation and safety. The document is aimed at supporting clinicians and informing patients, administrators and payers on opportunities and limitations of IL-6 pathway inhibition.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:84268
Year Published:2013
Web of Science® Times Cited:67
Deposited By:Menzies Institute for Medical Research
Deposited On:2013-05-01
Last Modified:2014-04-17
Downloads:309 View Download Statistics

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