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The safety and efficacy profiles in clinical trials of olokizumab, sarilumab and sirukumab are similar and are consistent with those observed in RA patients treated with tocilizumab. Furthermore, the clinical efficacy of these IL-6 inhibitors is similar to that of TNF inhibitors in patients with MTX-IR and TNF-IR. Screening of biomarkers or genetics in each RA patient, for instance, baseline serum levels of TNF and/or soluble IL-6R, may help to predict the efficacy of each drug and to select patients for cytokine-oriented targeted therapies.33 However, better strategies are warranted for selecting and identifying appropriate patients earlier once bDMARDs targeting IL-6 are launched in the near future. We also need to determine whether there are important differences between the many IL-6 inhibitors and which are suitable for particular patients, otherwise companies may waste time and money in development.
Via Krishan Maggon
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RA patients not responding to TNF inhibitors benefit from treatment with IL6 targeting mabs and show regression of RA disease.
Ann Rheum Dis 2014;73:1595-1597 doi:10.1136/annrheumdis-2013-205002
EditorialIL-6 targeting compared to TNF targeting in rheumatoid arthritis: studies of olokizumab, sarilumab and sirukumabYoshiya Tanaka1, Emilio Martin Mola2+Author Affiliations
1The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan2Servicio de Reumatología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, Madrid, SpainCorrespondence toProfessor Yoshiya Tanaka, The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu 807-8555, Japan; tanaka@med.uoeh-u.ac.jpReceived 31 January 2014Revised 23 April 2014Accepted 1 May 2014Published Online First 15 May 2014