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Targeting interleukin-6 pathways in giant cell arteritis management: A narrative review of evidence

Maxime Samson1, Bhaskar Dasgupta2, Anthony M Sammel3

  • 1Department of Internal Medicine and Clinical Immunology, Referal Centre for Rare auto-immune and auto-inflammatory systemic diseases (MAIS), University Hospital of Dijon; INSERM U1098, University of Bourgogne-Franche Comté, 21000 Dijon, France.

Autoimmunity Reviews
|December 7, 2024
PubMed

Insights

Interleukin-6 (IL-6) inhibitors offer a promising alternative to long-term glucocorticoids for giant cell arteritis (GCA) treatment. Tocilizumab effectively reduces inflammation and improves patient quality of life in GCA management.

Area of Science:

  • Rheumatology
  • Immunology
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a chronic inflammatory vasculitis impacting vascular health.
  • Current GCA treatment relies on glucocorticoids (GCs), often leading to adverse effects with prolonged use.
  • Non-specific GCA symptoms can delay diagnosis and effective management.

Purpose of the Study:

  • To review the efficacy and challenges of using interleukin-6 (IL-6) pathway inhibitors for GCA treatment.
  • To evaluate studies on IL-6 inhibition in GCA published between 2018 and 2024.
  • To highlight the potential of IL-6 blockade in reducing GC dependency and improving patient outcomes.

Main Methods:

  • Narrative review of key studies on IL-6 pathway inhibitors in GCA.
  • Focus on research from selected databases published between 2018 and 2024.
  • Analysis of clinical trial data and observational studies concerning tocilizumab and other IL-6 inhibitors.

Main Results:

  • IL-6 pathway inhibition demonstrates therapeutic benefits in GCA by reducing inflammation.
  • Tocilizumab, an IL-6 receptor inhibitor, shows efficacy in achieving sustained remission and enhancing quality of life.
  • GC-sparing effects were observed with IL-6 inhibitor therapy, mitigating long-term GC-related adverse events.

Conclusions:

  • IL-6 pathway inhibitors, particularly tocilizumab, represent a significant advancement in GCA management.
  • Further research is required to optimize treatment duration, manage relapses, and assess long-term vascular outcomes.
  • Balancing efficacy with safety is crucial for developing improved GCA treatment strategies.

Keywords:
Giant cell arteritisGlucocorticoidInterleukin-6Tocilizumab

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