ABSTRACT
Introduction: Interleukin-6 (IL-6) is well-known for its pro-inflammatory properties, has been proven to target a wide range of cells in the joint, and has been implicated in extra-articular and articular manifestations in rheumatoid arthritis (RA). Tocilizumab (TCZ) is now widely used in patients with active RA and a number of additional agents that target the IL-6 pathways are under development, including sirukumab (SRK).
Areas covered: SRK is an IgG1κ human anti-IL-6 monoclonal antibody which binds to IL-6 and prevents IL-6-mediated downstream effects. Initial trial results in phase-III studies in patients with RA seemed promising, showing improved results in patients with moderate-to-severe RA. Data derive from the phase-II study and the various SIRROUND studies (phase III).
Expert commentary: The available data show that SRK50 mg every 4 weeks or 100 mg every 2 weeks will be effective in treating the RA population, with clinical improvements as early as week 2 and sustained over time. The adverse-event profile seems to be similar to TCZ, except for an increased mortality post open-label studies due to infections and cardiovascular events, our knowledge of which will be deepened with post-marketing surveillance and registry data.
Declaration of interest
M Matucci Cerinic has the following disclosures: speaker bureau and research grant for BMS and Pfizer; Board of consultancy and research grant for Eli Lilly, Celgene and CSL Behring; speaker bureau and Board of consultancy for Actelion and Chemomab. DE Furst declares Grant/Research Support from Amgen, BMS Novartis, Pfizer and Roche/Genentech, consultancy for AbbVie, Amgen, BMS, Corbus, Cytori, Novartis, Pfizer and Roche/Genentech, and Speakers Bureau (CME or non-promotional only) for BMS, Abbvie. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Reviewer disclosures
A reviewer on this manuscript has disclosed they have received speaking fee and research grants from biologics companies. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.