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Review
. 2015 Dec;54(12):2134-44.
doi: 10.1093/rheumatology/kev269. Epub 2015 Jul 23.

Treating rheumatological diseases and co-morbidities with interleukin-1 blocking therapies

Giulio Cavalli  1 , Charles A Dinarello  2
Affiliations
Review

Treating rheumatological diseases and co-morbidities with interleukin-1 blocking therapies

Giulio Cavalli et al. Rheumatology (Oxford). 2015 Dec.

Abstract

The inflammatory cytokines IL-1α and IL-1β orchestrate local and systemic inflammatory responses underlying a broad spectrum of diseases. Three agents for reducing IL-1 activities are currently available. Anakinra is a recombinant form of the naturally occurring IL-1 receptor antagonist. Anakinra binds to the IL-1 receptor and prevents the activity of IL-1α and IL-1β. The soluble decoy receptor rilonacept and the neutralizing mAb canakinumab block IL-1β. A mAb directed against the IL-1 receptor and a neutralizing anti-human IL-1α are in clinical trials. The availability of therapies specifically targeting IL-1 unveiled the pathological role of IL-1-mediated inflammation in a broadening list of diseases. Conditions effectively treated with agents blocking IL-1 range from classic rheumatic diseases, such as RA and gout, to autoinflammatory syndromes, such as systemic JIA and FMF. However, IL-1 antagonism is also effective against highly prevalent inflammatory diseases, namely cardiovascular diseases and type 2 diabetes, conditions that are frequently encountered as co-morbidities in patients with rheumatic diseases. Thereby, IL-1 inhibition has the potential to lift the burden of disease for patients with rheumatic conditions, but also to provide clinical benefits beyond the efficacy on osteoarticular manifestations.

Keywords: IL-1α; IL-1β; anakinra; autoinflammatory syndromes; canakinumab; cardiovascular disease; diabetes; interleukin-1; rheumatoid arthritis.

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