[IL-1 antagonists].

Abstract

Interleukin (IL)-1 plays an important role not only in the mediation of inflammation but also in the destruction of cartilage and bone. Together with TNF-alpha it is one of the most important cytokines in the pathogenesis of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA). The first IL-1 antagonist to be approved for RA was Anakinra, an IL-1 receptor antagonist. Anakinra appears to be less effective for RA than TNF blockers. Hence, Anakinra is rarely used for the treatment of RA, but more for the treatment of IL-1-mediated diseases such as autoinflammatory syndromes, adult-onset Still's disease and systemic onset JIA. Two newer IL-1 antagonists have recently been approved for the treatment of CAPS (cryopyrin-associated periodic syndromes): Canakinumab, a fully human IL-1beta antibody, and rilonacept, a fusion protein consisting of the ligand-binding domain of the IL-1 receptor and the IL-1-receptor accessory protein, bound to human IgG1. For RA, there is only one proof-of-concept study to date with canakinumab. There are no prospective data for the treatment of patients with RA who did not respond to or tolerate TNF antagonists; in a retrospective analysis, only 8% of anti-TNF pretreated patients achieved an ACR 20 response.

• Authors: I Kötter, G Horneff
• Journal: Zeitschrift fur Rheumatologie (Z Rheumatol) Vol. 69 Issue 7 Pg. 581-93 (Sep 2010) ISSN: 1435-1250 [Electronic] Germany
• Vernacular Title: IL-1-Antagonisten.
• PMID: 20703489 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Interleukin 1 Receptor Antagonist Protein
• Interleukin-1
• Recombinant Fusion Proteins
• canakinumab
• rilonacept

Topics

• Adult
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents (therapeutic use)
• Humans
• Interleukin 1 Receptor Antagonist Protein (therapeutic use)
• Interleukin-1 (antagonists & inhibitors)
• Recombinant Fusion Proteins (therapeutic use)
• Rheumatic Diseases (drug therapy)