IL-6

Pleiotropic cytokine driving acute-phase response and joint destruction

Expression
Elevated
Evidence level
established
Targeted by
Tocilizumab

Role in pathogenesis

IL-6 serum levels are highly increased in both systemic and chronic articular AOSD phenotypes. IL-6 drives hepatic production of ferritin, CRP, and other acute-phase reactants, contributes to fever, and promotes joint destruction via osteoclast activation. IL-6 blockade with tocilizumab is particularly effective for the chronic articular phenotype and enables glucocorticoid sparing.

Targeting drugs (1)

DrugMechanismResponseLine
TocilizumabAnti-IL-6 receptor monoclonal antibody~61% (ACR50)2nd

Sources (3)

DetailsFeist E et al. (2018) Mechanisms, biomarkers and targets for adult-onset Still's disease · Nat Rev RheumatolPubMed
DetailsKaneko Y et al. (2018) Tocilizumab in patients with adult-onset Still's disease refractory to glucocorticoid treatment: a randomised, double-blind, placebo-controlled phase III trial · Ann Rheum DisPubMed
DetailsKontzias A et al. (2008) Adult-onset Still's disease: pathogenesis, clinical manifestations and therapeutic advances · DrugsPubMed