The role of interleukin-1 antagonists in treatment of inflammatory disorders: current experience and perspectives

The interleukin-1 (IL-1) family consists of IL-1a, IL-1b, interleukin-18, and the natural inhibitor of IL-1 receptor (IL-1 Ra). The recombinant IL-1Ra, anakinra is used as anti-inflammatory agent, and was approved in 2001 for the treatment of rheumatoid arthritis (RA). Recent years have brought new data on the effectiveness of IL-1 blockade in inflammatory disorders other than RA. It has been proved that anakinra is also effective in management of diseases that are resistant to conventional medication such as systemic-onset juvenile idiopathic arthritis, adult-onset Still disease, hereditary autoinflammatory syndromes, familial Mediterranean fever or even osteoarthritis or gout. Newer approaches to IL-1 blockade, including antibodies against IL-1 are also investigated in clinical trials in patients with type 2 diabetes mellitus, and systemic-onset juvenile idiopathic arthritis. Despite the earlier moderate efficacy of anakinra in management of patients with RA, modulation of proinflammatory signaling involving IL-1 seems to be very promising in elaboration of new biological drugs for several inflammatory disorders.