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Interleukin-6-Blockade als potenzielles therapeutisches Target bei entzündlich-rheumatischen Erkrankungen

Interleukin-6 inhibition as a potential therapeutic target in rheumatic diseases

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Zusammenfassung

Interleukin-6 (IL-6), ein 21-kDa-Glykoprotein, spielt als proinflammtorisches Zytokin eine wichtige Rolle in der akuten Immunantwort. IL-6 trägt daneben aber auch zur Aufrecherhaltung einer chronischen Entzündung und zur Entstehung verschiedener Autoimmunerkrankungen bei. Bisher ist der IL-6-Rezeptor-Antikörper Tocilizumab (TCZ, RoActemtra®) der einzige zugelassene therapeutische Ansatz zur Blockade von IL-6-Effekten. Er ist zur Behandlung der rheumatoiden Arthritis (RA), der systemischen und polyartikulären juvenilen idiopathischen Arthritis (sJIA und pJIA) sowie in Japan zur Behandlung der angiofollikulären Lymphknotenhyperplasie (M. Castleman) zugelassen. Zahlreiche Fallberichte und -serien geben einen Einblick in das weite Feld der therapeutischen Möglichkeiten durch eine IL-6-Hemmung. Aktuell befindet sich eine Vielzahl an Medikamenten mit IL-6 als Target in der klinischen Entwicklung. Somit werden dem Rheumatologen zukünftig wahrscheinlich verschiedene Substanzen auch für andere Indikationen außer der RA zur Verfügung stehen. Diese Arbeit soll einen Überblick über die aktuelle Datenlage bei verschiedenen Erkrankungen und den Entwicklungsstand einzelner Substanzen geben.

Abstract

As a pro-inflammatory cytokine, the 21-kDa glycoprotein interleukin-6 (IL-6) plays a crucial role in the initiation of acute inflammation, as well in the perpetuation of a chronic inflammatory immune response. Thus, IL-6 might be involved in the pathogenesis of various autoimmune diseases. So far, the IL-6-rezeptor-antibody tocilizumab (TCZ, RoActemtra®) is the only approved drug for the treatment of IL-6-mediated disease, including rheumatoid arthritis (RA), systemic juvenile idiopathic (sJIA) and polyarticular juvenile arthritis (pJiA), as well as Castleman’s disease (in Japan only). In recent years, an emerging number of case reports and small uncontrolled case series have reported on the successful treatment of various other chronic inflammatory diseases, which has resulted in the idea of a broad therapeutic potential for IL-6 blockade. Numerous IL-6 targets are currently in phase II/III study programs for RA as well as for other indications. This review focuses on the development of tocilizumab and other IL-6 targets as a therapeutic option for various diseases in rheumatology.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Iking-Konert: Honorare und/oder finanzielle Zuwendung durch Studien von Chugai, Roche, UCB und Pfizer. P. Bartz-Bazzanella und D. Falagan: Referentenhonorare von Chugai. M. Hofman: Mitarbeiter Chugai Pharma. A. Schwarting und T. Dörner. Keine Angaben.

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Authors and Affiliations

  1. III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf , Martinistr. 52 , 20246, Hamburg, Deutschland

    C. Iking-Konert

  2. Klinik für Internistische Rheumatologie, Medizinisches Zentrum der Städte Region Aachen, Würselen, Deutschland

    P. Bartz-Bazzanella

  3. Rheumatologie, Kliniken Essen Süd, Essen, Deutschland

    D. Falagan

  4. Chugai Pharma Marketing Ltd., Frankfurt , Deutschland

    M.W. Hofman

  5. Universitätsmedizin I. Medizinische Klinik, Universitätsmedizin, Mainz, Deutschland

    A. Schwarting

  6. Rheumatologie Charité - Universitätsmedizin Berlin, Berlin, Deutschland

    T. Dörner

Authors
  1. C. Iking-Konert
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  2. P. Bartz-Bazzanella
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  3. D. Falagan
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  4. M.W. Hofman
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  5. A. Schwarting
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  6. T. Dörner
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Correspondence to C. Iking-Konert.

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Iking-Konert, C., Bartz-Bazzanella, P., Falagan, D. et al. Interleukin-6-Blockade als potenzielles therapeutisches Target bei entzündlich-rheumatischen Erkrankungen. Z. Rheumatol. 73, 269–276 (2014). https://doi.org/10.1007/s00393-013-1268-9

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  • DOI: https://doi.org/10.1007/s00393-013-1268-9

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