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Anti-inflammatory panacea? The expanding therapeutics of interleukin-1 blockade.

Purpose Of Review: Blockade of interleukin (IL)-1 signaling is one of the oldest biologic therapies, yet the use of these agents is on the rise as the role of IL-1 activation is being recognized in a wide spectrum of inflammatory disorders. This review will cover established and emerging uses of IL-...

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Published in:Current Opinion in Rheumatology Vol. 28; no. 3; pp. 197 - 204
Main Author: Kahlenberg, J. Michelle
Format: research Journal Article
Published: Lippincott Williams & Wilkins May2016
Online Access:View this record in EBSCOhost
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      dt: May2016
      vid: 28
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Anti-inflammatory panacea? The expanding therapeutics of interleukin-1 blockade.
      aug:
        au: Kahlenberg, J. Michelle
        affil: Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
      sug:
        subj:
          Antiinflammatory Agents Therapeutic Use
          Interleukin 1 Antagonists and Inhibitors
          Rheumatic Diseases Drug Therapy
          Human
          Rheumatic Diseases Metabolism
          Interleukin 1 Metabolism
          Scales
      ab: Purpose Of Review: Blockade of interleukin (IL)-1 signaling is one of the oldest biologic therapies, yet the use of these agents is on the rise as the role of IL-1 activation is being recognized in a wide spectrum of inflammatory disorders. This review will cover established and emerging uses of IL-1 antagonism in rheumatic diseases.Recent Findings: Expanding off-label indications for IL-1 blockade include neutrophil-dominant skin diseases, including pyoderma gangrenosum, hidradenitis supperativa, and pustular psoriasis. There is also increasing evidence for the use of IL-1 blockade in heart failure associated with rheumatic diseases. Somatic mosaicism in NLRP3 may explain the onset of later-in-life presentations of periodic fevers which are responsive to IL-1 blockade. Of importance, clinical response to anti-IL-1 therapy does not always denote protection from autoinflammatory disease complications such as macrophage activation syndrome or amyloidosis.Summary: Indications for IL-1 blocking therapies will likely continue to broaden, but given the rarity of many rheumatic diseases which respond to such treatment, rigorous, large clinical trials for each indication are unlikely to occur. Thus, recommended use of these medications will often fall to the discretion of the astute physician. However, medication cost and hurdles of insurance approval, rather than drug efficacy, may be the primary limitation for more widespread use.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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