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  •   Considering IL-6
    Consid. Med. Pub Date : 2018-11-01
    Iain McInnes

    Targeting interleukin (IL)−6 or its receptor for the treatment of inflammatory disease is an attractive approach to the management of complex inflammatory diseases, especially those with a systemic component to their presentation and comorbidity. Biological drugs that target IL-6 receptor are already in clinical practice. Recently, more agents are emerging from clinical trials that block distinct parts

  •   Interleukin 6: The biology behind the therapy
    Consid. Med. Pub Date : 2018-11-01
    Simon A Jones, Tsutomu Takeuchi, Daniel Aletaha, Josef Smolen, Ernest H Choy, Iain McInnes

    The cytokine interleukin (IL)−6 performs a diverse portfolio of functions in normal physiology and disease. These functions extend beyond the typical role for an inflammatory cytokine, and IL-6 often displays hormone-like properties that affect metabolic processes associated with lipid metabolism, insulin resistance, and the neuroendocrine system. Consequently, the biology of IL-6 is complex. Recent

  •   Considering new lessons about the use of IL-6 inhibitors in arthritis
    Consid. Med. Pub Date : 2018-11-01
    Tsutomu Takeuchi, Josef S Smolen, Ernest H Choy, Daniel Aletaha, Iain McInnes, Simon A Jones

    Interleukin (IL)−6 represents one of several possible targets for the treatment of rheumatoid arthritis. Drugs targeting IL-6 can be divided into monoclonal antibodies against IL-6 itself and monoclonal antibodies against the IL-6 receptor. Both types of agent inhibit both classical signalling through membrane­-bound IL-6 receptor, and trans-signalling via formation of a complex between IL-6 and soluble

  •   Targeting IL-6: A review of data
    Consid. Med. Pub Date : 2018-11-01
    Josef S Smolen, Daniel Aletaha, Ernest H Choy, Simon A Jones, Tsutomu Takeuchi, Iain McInnes

    Compounds that target interleukin (IL)−6 pathways include antibodies against the IL-6 receptor or ligand, and inhibitors of IL-6 signal transduction. The anti-IL-6 receptor (IL-6R) monoclonal antibody tocilizumab has been licensed for several years; data from multiple studies demonstrate its efficacy and tolerability in rheumatoid arthritis as monotherapy or in combination with methotrexate. In addition

  •   IL-6: To immunity and beyond
    Consid. Med. Pub Date : 2018-11-01
    Ernest H Choy, Simon A Jones, Daniel Aletaha, Tsutomu Takeuchi, Iain McInnes, Josef Smolen

    Interleukin (IL)−6 inhibition has been approved for the treatment of rheumatoid arthritis, systemic juvenile arthritis, polyarticular juvenile idiopathic arthritis, giant cell arteritis, and, in some countries, Castleman’s disease. IL-6 has also been implicated in several non-rheumatoid arthritis inflammatory and immune conditions such as systemic sclerosis, vasculitides, systemic lupus erythematous

  •   The biosimilar approval process: how different is it?
    Consid. Med. Pub Date : 2017-10-01
    John Isaacs,João Gonçalves,Robert Strohal,Gilberto Castañeda-Hernández,Valderilio Azevedo,Thomas Dörner,Iain McInnes

    Biosimilars are biotherapeutic products with similar efficacy, safety, and quality to a licensed bio-originator. Biosimilars include monoclonal antibodies, soluble receptors, growth factors, and hormones. The manufacture of biosimilars is a sophisticated multi-step process; factors at each stage, such as production cell line, culture conditions, and formulation, may each alter the final product through

  •   Biosimilars: considerations for clinical practice
    Consid. Med. Pub Date : 2017-10-01
    Valderilio Azevedo,Thomas Dörner,Robert Strohal,John Isaacs,Gilberto Castañeda-Hernández,João Gonçalves,Iain McInnes

    With the projected expansion of the biosimilars market, there will be an increased propensity for the substitution of reference biological products with cheaper biosimilars for economic reasons (ie, non-medical switching). This will lower the cost per patient and should provide the benefit of wider access to biological therapies. However, it is essential that patients and clinicians fully understand

  •   Considering biosimilars in inflammatory diseases
    Consid. Med. Pub Date : 2017-10-01
    Iain McInnes

    With the projected expansion of the biosimilars market, clinicians must assimilate many important issues. These include understanding biosimilar development, building strategies for biosimilar introduction, and developing robust systems for biosimilar pharmacovigilance. With ten tumour necrosis factor inhibitors, a first rituximab biosimilar now on the market, and many more biosimilars currently in

  •   Biosimilars already approved and in development
    Consid. Med. Pub Date : 2017-10-01
    Thomas Dörner,John Isaacs,João Gonçalves,Valderilio Azevedo,Gilberto Castañeda-Hernández,Robert Strohal,Iain McInnes

    As of mid-2017, 10 tumour necrosis factor inhibitors (four for etanercept and three each for adalimumab and infliximab) and a first rituximab biosimilar are on the market, and a considerable number more are in various stages of development. The clinical trials of biosimilars, which have included long term extensions, have used various designs to look at switching between originator and biosimilar products

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