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Letter
Evidence of response to IL-6 inhibition in some cases of refractory spondyloarthritis-associated peripheral synovitis
  1. Mira Merashli1,2,
  2. Gabriele De Marco1,2,
  3. Mark Podgorski3,
  4. Dennis McGonagle1,2,
  5. Helena Marzo-Ortega1,2
  1. 1 NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  3. 3 Department of Rheumatology, Hornsby Kuringai Hospital, Sydney, Australia
  1. Correspondence to Dr Helena Marzo-Ortega, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Second floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; H.Marzo-Ortega{at}leeds.ac.uk

https://doi.org/10.1136/annrheumdis-2016-209275

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    Spondyloarthritis (SpA) is a complex polygenic disorder with mixed clinical phenotype. Pro-inflammatory cytokines, including tumour necrosis factor (TNF), interleukin (IL)-17 and IL-23, play key pathogenetic roles in SpA, with their blockade being effective in many, but not all cases. Inhibition of IL-6 effectively suppresses synovitis in rheumatoid arthritis (RA)1 but has failed to show efficacy in ankylosing spondylitis (AS), the prototype SpA, in two controlled clinical trials.2 ,3 This is surprising since genetic and experimental studies indicate a potential role for IL-6 in some SpA subsets.4–6 Here, we report our experience in four men with AS and severe, recurrent peripheral synovitis. Detailed clinical and laboratory characteristics are summarised in table 1 but briefly they all fulfilled the modified New York criteria for AS with two cases (2 and 4) …

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    Footnotes

    • Contributors MM wrote the manuscript; GdM contributed to the writing and editing; MP contributed one of the clinical cases; DGM contributed scientific input; HM-O conceived the idea for the manuscript and contributed three of the cases. All authors edited the manuscript and approved the final version.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.