RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 482
OP 492
DO 10.1136/annrheumdis-2012-202469
VO 72
IS 4
A1 Josef S Smolen
A1 Monika M Schoels
A1 Norihiro Nishimoto
A1 Ferdinand C Breedveld
A1 Gerd R Burmester
A1 Maxime Dougados
A1 Paul Emery
A1 Gianfranco Ferraccioli
A1 Cem Gabay
A1 Allan Gibofsky
A1 Juan Jesus Gomez-Reino
A1 Graeme Jones
A1 Tore K Kvien
A1 Miho Murakami
A1 Neil Betteridge
A1 Clifton O Bingham III
A1 Vivian Bykerk
A1 Ernest H Choy
A1 Bernard Combe
A1 Maurizio Cutolo
A1 Winfried Graninger
A1 Angel Lanas
A1 Emilio Martin-Mola
A1 Carlomaurizio Montecucco
A1 Mikkel Ostergaard
A1 Karel Pavelka
A1 Andrea Rubbert-Roth
A1 Naveed Sattar
A1 Marieke Scholte-Voshaar
A1 Yoshiya Tanaka
A1 Michael Trauner
A1 Gabriele Valentini
A1 Kevin L Winthrop
A1 Maarten de Wit
A1 Désirée van der Heijde
YR 2013
UL http://ard.bmj.com/content/72/4/482.abstract
AB 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.