Vobarilizumab Anti-interleukin-6 receptor subunit alpha (CD126; IL-6R) Treatment of rheumatoid arthritis Treatment of systemic lupus erythematosus

摘要

The development of monoclonal antibodies targeting proinflammatory mediators has revolutionized treatment for patients with rheumatoid arthritis who have failed to show an adequate clinical response to disease-modifying antirheumatic drugs. However, a significant number of patients continue to show unacceptable levels of disease activity. Tocilizumab and sarilumab, both anti-interleukin-6 receptor (IL-6R) antibodies, have great efficacy in such patients, but have been associated with some unwanted side effects. The European League Against Rheumatism and American College of Rheumatology consensus is that new treatments should induce and maintain remission, while minimizing side effects. Vobarilizumab (ALX-0061) is a bispecific Nanobody that targets IL-6R and human serum albumin. The latter of which significantly extends its serum half-life. Both tocilizumab and vobarilizumab target the soluble and membrane-bound forms of the receptor, but vobarilizumab has much greater affinity for the soluble receptor, which is believed to be associated with the proinflammatory action of IL-6. In phase II clinical trials, both drugs showed similar efficacy but vobarilizumab use was associated with fewer adverse events. Vobarilizumab reduced disease activity scores and induced lasting remission and is expected to enter phase III trials in the near future.