Interleukin 6 Receptor Inhibitor Levilimab in the Treatment of Rheumatoid Arthritis

Abstract

The inhibitors of the biological effects of interleukin 6 (IL-6) are the most actively developing group of biologics for the treatment of rheumatoid arthritis (RA) due to pleiotropic effects of this most important pro-inflammatory cytokine, which stimulates a number of processes that play an important role in the pathogenesis of RA. IL-6 receptor (IL-6R) is of great importance in the implementation of these biological effects. Activation of IL-6R occurs with the participation of the glycoprotein gp130 in three variants: classical, and in trans-signaling and trans-presentation modes. The most recent representative of this group is levilimab, an IgG1 monoclonal antibody to IL-6R that binds both soluble and membrane forms of the receptor. The efficacy and safety of levilimab has been demonstrated in the Phase II AURORA and Phase III SOLAR trials. The paper presents the main statements of the resolution of the regional expert council of rheumatologists of Moscow and the Moscow Region on the topic: ‘The place of a new IL-6R inhibitor levilimab in the treatment of patients with rheumatoid arthritis’, which took place on December 18, 2021 in Moscow. The panel of experts confirmed that levilimab is recommended for widespread use in patients with active RA who fail or are intolerant to traditional synthetic DMARDs.