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Sarilumab: patient-reported outcomes in rheumatoid arthritis

Authors Crotti C, Biggioggero M, Becciolini A, Favalli EG

Received 9 April 2018

Accepted for publication 20 June 2018

Published 20 August 2018 Volume 2018:9 Pages 275—284


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Lynne Nemeth

Chiara Crotti,1,2 Martina Biggioggero,3 Andrea Becciolini,3 Ennio Giulio Favalli3

1Department of Clinical Sciences and Health Community, University of Milan, 2Division of Rheumatology, Gaetano Pini Institute, Milan, Italy; 3Department of Rheumatology, Gaetano Pini Institute, Milan, Italy

Abstract: In the last few decades, strategies for the management of rheumatoid arthritis (RA) have been increasingly oriented toward more comprehensive control of the disease, taking into account even RA extra-articular manifestations, comorbidities, and the patient’s perception about the disease. The need for improving the shared decision-making process suggested by European League Against Rheumatism recommendations is leading to an increasing interest in the role of patient-reported outcomes (PROs) beside the usual more objective criteria for defining clinical response based on disease-activity composite indices. Measurement of such PROs as pain or fatigue may be significantly influenced by mood disorders often complicating RA, the pathogenesis of which is deeply interconnected with phlogistic processes mediated by proinflammatory cytokines. IL6 is a pleiotropic mediator involved in neuroendocrine and neuropsychological processes, besides its well known effects on immune, cardiovascular, and metabolic systems. Therefore, there is a growing body of evidence about the efficacy of IL6 blockade in PRO improvement in RA patients. Sarilumab is a monoclonal antibody binding both soluble and membrane-bound IL6Rα, inhibiting the IL6-mediated signaling pathway with favorable efficacy and safety profile. This review analyzes the importance of PROs in strategies for the management of RA and the pathogenic mechanisms linking IL6 with the patient’s perception of the disease. Moreover, the main findings from sarilumab randomized controlled trials are summarized in detail, emphasizing the potential role of this IL6 blocker in the holistic treatment of RA.

Keywords: rheumatoid arthritis, interleukin-6, sarilumab, patient reported outcome

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