The symposium discussed mechanisms of interleukin (IL)-6 blockade for the treatment and management of patients with rheumatoid arthritis (RA). Prof Smolen provided a clinical update of the latest efficacy and safety data on various anti-IL-6 drugs, including sirukumab. He noted that all anti-IL-6 drugs were efficacious in treating physical and mental symptoms of RA. When the efficacy of anti-IL-6 antibodies was compared between drugs, targeting the IL-6 ligand was similar to targeting its receptor. Prof Pitzalis described the pathophysiology of IL-6 in RA and the reason for targeting IL-6. Lastly, Prof Choy outlined the importance of measuring patient-reported outcomes to monitor symptom improvement and evaluate the impact of IL-6 on mental functioning. Because IL-6 modulates the hypothalamic pituitary axis, fatigue and depression are common in patients with RA. Evidence suggests that the inhibition of IL-6 activity reduces symptoms of fatigue and depression in patients with RA, and that improvement in mental health
occurs independently, rather than as a consequence of improvement in physical functioning.
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