Blocking Il1 In Patients With Rheumatoid Arthritis With The Il1 Receptor Antagonist

The basic concept of inhibition of ICE to reduce the processing and secretion of IL-ip in disease states received a great deal of support following the publication of clinical trials of IL-1 receptor antagonist (IL-IRa) in patients with rheumatoid arthritis and graft versus host disease. Also, the importance of endogenous IL-IRa in patients with rheumatoid arthritis is supported by a study using the administration of soluble IL-1R type I to these patients. Since the soluble form of IL-1R type I binds IL-IRa with a greater and near irreversible affinity than that of IL-1 a or IL-ip, the use of the soluble IL-1R type in humans worsened disease in these patients (21). Although IL-iRa was used in three trials to reduce 28-day mortality in sepsis, the overall success of any anticytokine-based therapy in this patient population precludes any conclusion whether the anticytokine is effective (22-24). In each of these three trials, there was clear evidence of improved outcome in subgroups treated with IL-1Ra compared to placebo-treated patients. However, in each trial, the entire group did not reach a statistically significant reduction in mortality. On the other hand, the use of IL-1Ra is patients with rheumatoid arthritis and graft versus host disease provides convincing evidence that blocking IL-1 reduces disease and, moreover, blocking IL-1 is safe. Of course, inhibition of IL-1P is not the sole effect of ICE inhibition, and the lack of specificity of this strategy in humans may yield different results when it is used in the same diseases.

Arthritis Relief Now

Arthritis Relief Now

When you hear the word arthritis, images of painful hands and joints comes into play. Few people fully understand arthritis and this guide is dedicated to anyone suffering with this chronic condition and wants relief now.

Get My Free Ebook


Post a comment