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This article is part of the supplement: Interleukin-6, a pleiotropic cytokine

Highly Accessed Review

Interleukin-6: a new therapeutic target

Josef S Smolen1* and Ravinder N Maini2

Author Affiliations

1 Professor of Medicine, Chairman Division of Rheumatology, Medical University of Vienna, Vienna, Austria

2 Emeritus Professor of Rheumatology, The Kennedy Institute of Rheumatology Division, Imperial College, London, UK

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Arthritis Research & Therapy 2006, 8(Suppl 2):S5  doi:10.1186/ar1969

Published: 28 July 2006

Abstract

The therapeutic success of biological agents, especially the tumour necrosis factor (TNF) inhibitors, has opened a new chapter in the book of therapies for rheumatoid arthritis. Nevertheless, more than 50% of patients may not respond by > 50% improvement. New compounds have recently entered the treatment arena. One of these is rituximab, which depletes B cells, and another, abatacept, interferes with T-cell co-stimulation. However, although these agents may be effective in a number of patients who fail to respond to TNF blockade, they only rarely induce remission and overall 50% response rates do not exceed those with the TNF inhibitors. Among the major proinflammatory cytokines, IL-6 plays a pleiotropic role both in terms of activating the inflammatory response and osteoclastogenesis. Here, we review recent phase II trials of tocilizumab, a humanized anti-IL-6 receptor antibody that achieves a significant therapeutic response rate.