Journal Article

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

Kremer, Joel M, Fleischmann, Roy M, Takeuchi, Tsutomu, Betteridge, Neil, Winthrop, Kevin L, Voshaar, Marieke, Tanaka, Yoshiya, Kerschbaumer, Andreas, Smolen, Josef S, Trauner, Michael, Hyrich, Kimme L, Bykerk, Vivian, Dougados, Maxime, Merkel, Peter A, Nurmohamed, Michael T, Isaacs, John D, Pavelka, Karel, Kastrati, Kastriot, Caporali, Roberto, Hetland, Merete Lund, Mariette, Xavier, Combe, Bernard, Aletaha, Daniel, Mysler, Eduardo F, Rubbert-Roth, Andrea, de Wit, Maarten, Gabay, Cem, Schulze-Koops, Hendrik, Bijlsma, Johannes WJ, Sattar, Naveed, Burmester, Gerd-Rüdiger R, Nash, Peter, van der Heijde, Désirée, Codreanu, Catalin, Poor, Gyula, McInnes, Iain B, Stamm, Tanja A, Ravelli, Angelo, Choy, Ernest H, Strangfeld, Anja, Crow, Mary K, Dejaco, Christian, Emery, Paul, Iagnocco, Annamaria

2023

Overview

BackgroundTargeting 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-6Rα 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.MethodsA 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.ResultsThe 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.ConclusionsThe 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.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier Limited
• Subject: Adult / Arteritis / Arthritis, Rheumatoid - drug therapy / autoimmune diseases / Binding sites / biological therapy / Cell growth / Chimeric antigen receptors / Clinical aspects / COVID-19 / Cytokines / Humans / Inflammation / Inflammation - drug therapy / Inflammatory diseases / Interleukin 6 / Kinases / Ligands / Lymphocytes T / Monoclonal antibodies / Neuromyelitis / Patients / Receptors, Interleukin-6 - antagonists & inhibitors / Recommendation / Rheumatoid arthritis / Rheumatology / Signal transduction / Still's Disease, Adult-Onset - drug therapy / Takayasu's disease / Tumor necrosis factor-TNF / Vein & artery diseases