A potentially significant side effect of IL-6 receptor antibodies

An antibody that blocks interleukin-6 (IL-6) receptors as medication (for example, interleukin-6tocilizumab (RoActemra, Roche)) has an additional side effect in the form of increased belly fat.

Pathological role of IL-6 in rheumatoid arthritis. IL-6 is important for development of Th17 and induction of autoantibodies such as rheumatoid factor. Activated Th17 cells and autoantibodies generate pannus in combination with activated fibroblastic synoviocytes, macrophages, and lymphocytes. Inflamed synovitis such as pannus is a major source of inflammatory cytokines including IL-6, and systemic inflammation (resulting in production of acute phase protein, anemia, and fatigue) is mainly mediated by IL-6. Tumor necrosis factor (TNF) plays a major role in the progression of local types of inflammation (arthritis) such as arthralgia, swelling, and joint destruction but plays a minor role during the priming phase.

We should keep in mind these data especially when we treat obese patients with rheumatoid arthritis.

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