Sirukumab for the treatment of rheumatoid arthritis: update on sirukumab, 2018

  • Expert Rev Clin Immunol. 2018 Jul;14(7):539-547. doi: 10.1080/1744666X.2018.1487291.
Francesca Bartoli  1 ,  Sangmee Bae  2 ,  Laura Cometi  1 ,  Marco Matucci Cerinic  1 ,  Daniel E Furst  3  4  5  6  7
Affiliations
  • 1. a Department of Experimental and Clinical Medicine , University of Florence & Department of Geriatric Medicine, Division of Rheumatology, AOUC , Florence , Italy.
  • 2. b Division of Rheumatology Fellow , Geffen School of Medicine at the University of California in Los Angeles , Los Angeles , California, USA.
  • 3. c Geffen School of Medicine at the University of California in Los Angeles (Emeritus), California, USA.
  • 4. d Department of Experimental and Clinical Medicine , University of Florence , Florence , Italy.
  • 5. e University of Washington , Seattle , Washington DC , USA.
  • 6. f Pacific Arthritis , Los Angeles , California , USA.
  • 7. g Seattle Rheumatology Associates , Seattle , Washington, DC, USA.
PMID: 29925278 DOI: 10.1080/1744666X.2018.1487291
Abstract

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.

Keywords
Irukumab; biologics; interleukin 6 inhibitor; rheumatoid arthritis; tocilizumab.
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