Interleukin-1 and Interleukin-6 Inhibitor – Immunosuppressive Drugs

00:02 Let’s take a look at an interleukin-1 blocker.

00:04 Now, Kineret is a well-known drug, it is an interleukin-1 antagonist It is an interleukin-1 antagonist that inhibits the binding of interleukin-1 to the interleukin-1 type 1 receptor.

00:16 This interferes with the pro-inflammatory effects of IL-1, a key cytokine involved in various inflammatory and autoinflammatory conditions.

00:25 It is often used in the treatment of rheumatoid arthritis, but we also can use it in other autoimmune diseases.

00:32 Now avoid this medication in patients who have active infections.

00:36 It makes sense that suppressing the immune system in a person who's sick and infected is not gonna end well.

00:44 Avoid this drug in latent tuberculosis so even though they don’t have an active infection you can risk people getting very sick in the case of a reactivation.

00:54 Perform a tuberculin skin test or interfere on gamma release assay to rule out latent TB and test for chronic hepatitis B and C infection.

01:03 Avoid this drug in patients who have low white blood cell counts and avoid this drug on people who have been taking tumor necrosis factor inhibitors.

01:13 The adverse events associated with this medication usually, all of them I would say, injection site reactions but also look out for some neurological symptoms like headaches.

01:24 Sometimes you can have rise in cholesterol through an unknown mechanism and finally severe infection.

01:30 So we have seen patients for example who this medication for the treatment of their rheumatoid arthritis end up in the hospital with quite severe life-threatening infections so be very aware that sometimes these drugs can have serious consequences if they're not given to the right patient.

01:48 Next we have the interleukin-6 inhibitors.

01:51 Now these blockers of interleukin-6 are often used in rheumatoid arthritis - systemic rheumatoid arthritis and juvenile rheumatoid arthritis.

02:01 We also have used it in patients who have multiple myeloma and, in some cases, now we're starting to use it in prostate cancer.

02:08 It seems counter intuitive to use an IL-6 inhibitor in prostate cancer but there are certain mechanisms that actually reduce the progression of prostate cancer using IL-6 inhibitors.

02:21 It is also used in COVID-19 since elevated IL-6 levels are a hallmark of the hyperinflammatory response seen in severe COVID-19, which can lead to acute respiratory distress syndrome and multi-organ failure.