TY - JOUR T1 - Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 482 LP - 492 DO - 10.1136/annrheumdis-2012-202469 VL - 72 IS - 4 AU - Josef S Smolen AU - Monika M Schoels AU - Norihiro Nishimoto AU - Ferdinand C Breedveld AU - Gerd R Burmester AU - Maxime Dougados AU - Paul Emery AU - Gianfranco Ferraccioli AU - Cem Gabay AU - Allan Gibofsky AU - Juan Jesus Gomez-Reino AU - Graeme Jones AU - Tore K Kvien AU - Miho Murakami AU - Neil Betteridge AU - Clifton O Bingham III AU - Vivian Bykerk AU - Ernest H Choy AU - Bernard Combe AU - Maurizio Cutolo AU - Winfried Graninger AU - Angel Lanas AU - Emilio Martin-Mola AU - Carlomaurizio Montecucco AU - Mikkel Ostergaard AU - Karel Pavelka AU - Andrea Rubbert-Roth AU - Naveed Sattar AU - Marieke Scholte-Voshaar AU - Yoshiya Tanaka AU - Michael Trauner AU - Gabriele Valentini AU - Kevin L Winthrop AU - Maarten de Wit AU - Désirée van der Heijde Y1 - 2013/04/01 UR - http://ard.bmj.com/content/72/4/482.abstract N2 - 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. ER -