TARGETING IL-6 signaling shows reassuring safety and effectiveness in older patients with rheumatoid arthritis (RA), according to recent postmarketing and registry data. IL-6 plays a central role in amplifying inflammation, and its inhibition has become a key therapeutic strategy in managing immune-mediated inflammatory diseases such as RA.
Concerns have persisted regarding infection risk, particularly among older adults, where age is a known risk factor for serious adverse events. However, surveillance studies of sarilumab in Japan and registry data on tocilizumab from France, Germany, and Japan indicate that anti-IL-6 receptor therapies are generally well tolerated in this population. Importantly, these therapies did not appear to increase the risk of cardiovascular events or malignancies.
Effectiveness outcomes varied slightly between agents. Tocilizumab demonstrated somewhat reduced effectiveness in older patients compared with younger ones, whereas sarilumab effectiveness was consistent across age groups. This distinction underscores the need for careful treatment selection tailored to the patient’s age and comorbidity profile.
As global populations age and the prevalence of RA rises, the role of IL-6 inhibition is likely to grow. Beyond RA, expanding use of anti-IL-6 receptor antibodies in other immune-mediated inflammatory diseases is anticipated, particularly in superaged societies. These findings provide clinicians with important reassurance that IL-6 blockade remains a viable therapeutic option for older adults, balancing efficacy with a manageable safety profile.
Reference: Kameda H et al. Targeting IL-6 Signaling: Safety and Effectiveness in Older Patients with Rheumatoid Arthritis. Drugs Aging. 2025. doi: 10.1007/s40266-025-01248-8
