Consensus statement on blocking interleukin-6 receptor and interleukin-6 in inflammatory conditions: an update

Daniel Aletaha*, Andreas Kerschbaumer, Kastriot Kastrati, Christian Dejaco, Maxime Dougados, Iain B. McInnes, Naveed Sattar, Tanja A. Stamm, Tsutomu Takeuchi, Michael Trauner, Désirée Van Der Heijde, Marieke Voshaar, Kevin L. Winthrop, Angelo Ravelli, Neil Betteridge, Gerd Rüdiger R. Burmester, Johannes W.J. Bijlsma, Vivian Bykerk, Roberto Caporali, Ernest H. ChoyCatalin Codreanu, Bernard Combe, Mary K. Crow, Maarten De Wit, Paul Emery, Roy M. Fleischmann, Cem Gabay, Merete Lund Hetland, Kimme L. Hyrich, Annamaria Iagnocco, John D. Isaacs, Joel M. Kremer, Xavier Mariette, Peter Merkel, Eduardo F. Mysler, Peter Nash, Michael T. Nurmohamed, Karel Pavelka, Gyula Poor, Andrea Rubbert-Roth, Hendrik Schulze-Koops, Anja Strangfeld, Yoshiya Tanaka, Josef S. Smolen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Scopus)
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Background: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6Rα antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, based on most recent evidence and expert opinion, that aims to inform on the medical use of interfering with the IL-6 pathway. Methods: A systematic literature research was performed that focused on IL-6-pathway inhibitors in inflammatory diseases. Evidence was put in context by a large group of international experts and patients in a subsequent consensus process. All were involved in formulating the consensus statements, and in the preparation of this document. Results: The consensus process covered relevant aspects of dosing and populations for different indications of IL-6 pathway inhibitors that are approved across the world, including rheumatoid arthritis, polyarticular-course and systemic juvenile idiopathic arthritis, giant cell arteritis, Takayasu arteritis, adult-onset Still's disease, Castleman's disease, chimeric antigen receptor-T-cell-induced cytokine release syndrome, neuromyelitis optica spectrum disorder and severe COVID-19. Also addressed were other clinical aspects of the use of IL-6 pathway inhibitors, including pretreatment screening, safety, contraindications and monitoring. Conclusions: The document provides a comprehensive consensus on the use of IL-6 inhibition to treat inflammatory disorders to inform healthcare professionals (including researchers), patients, administrators and payers.

Original languageEnglish
Pages (from-to)773-787
JournalAnnals of the rheumatic diseases
Early online date11 Aug 2022
Publication statusPublished - 11 May 2023


  • Autoimmune diseases
  • Biological therapy
  • Rheumatoid arthritis


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