synovial fluid of patients with rheumatoid arthritis
and plays a critical role in disease progression1,2
AND SYSTEMIC EFFECTS1,2
- IL-6, a multifunctional cytokine, works via a dual signaling mechanism (classical or cis-signaling and trans-signaling)
- When persistently elevated in RA, IL-6 can disrupt homeostasis in a wide variety of physiological processes
stiffness, and other articular and systemic effects of RA2-5
In a single-center controlled study, mean serum IL-6 levels were approximately 10x higher in patients with RA (n=66) than in control group (n=24)7†
Placement of systemic and articular labels on image is for illustrative purposes only.
*The study results demonstrated that the circulating levels of IL-6 were increased in the morning in patients with RA and declined from early in the afternoon to late in the evening.6
†Serum concentrations of IL-6 were measured in healthy subjects and adult patients with RA and the levels were correlated with disease activity.7
IL-6=interleukin-6; RA=rheumatoid arthritis; CRP=C-reactive protein.
ON CURRENT TREATMENT
biologic at 1 year of initiating their first biologic9,10
If treatment target of remission or low disease activity is not achieved in patients with moderate or high disease activity despite the use of MTX or a TNF inhibitor:
- Treat with a biologic agent with another mechanism of action or a second TNF inhibitor
*2021 American College of Rheumatology Guidelines and 2019 EULAR Recommendations.
ACR20=American College of Rheumatology 20% improvement criteria; TNF=tumor necrosis factor; EULAR=European League Against Rheumatism; MOA=mechanism of action; TNF-IR=tumor necrosis factor inhibitor inadequate response or intolerant; MTX=methotrexate.