IL-6 blockade

Interleukin-6 (IL-6) plays an important role in the pathogenesis of rheumatoid arthritis (RA). Tocilizumab, anti-human IL-6 receptor monoclonal antibody developed in Japan, prevents IL-6 from binding to IL-6 receptor blocking IL-6 signal. The clinical and radiographic efficacy of tocilizumab has proved in many clinical studies. Tocilizumab monotherapy is superior to methotrexate, which has not proved in TNF inhibitors, although tocilizuab in combination with methotrexate is more effective than tocilizumab monotherapy in inducing remission. Hepatotoxicity and infection are adverse events to be careful about.