Interleukin and Arthritis Pain

For some time, specialists who study arthritis have been interested in a substance called interleukin-6 (IL-6). IL-6 is a chemical that produces inflammatory effects in the body, and levels of IL-6 are elevated in people who have rheumatoid arthritis (RA). In a piece published in the journal Rheumatology, two rheumatologists presented the results of a systematic review of articles published on pain and mood in RA since 2005. They wanted to learn more about what effect IL-6 might have on pain, mood, and fatigue in people with RA.

The evidence, the authors concluded, supports the theory that IL-6 plays a key role in the development of RA-related fatigue. It also appears that a relationship exists between IL-6 and mood disorders — for one, the research showed that IL-6 is one of the most consistently elevated chemicals in RA patients with major depressive disorder. In addition, IL-6 plays a major role in stimulating what’s known as the hypothalamic-pituitary-adrenal (HPA) axis, which is the body’s central stress-response system, and patients with RA have impaired activity of the HPA axis. Finally, drugs that inhibit IL-6 (for example, tocilizumab [brand name Actemra], sarilumab [Kevzara], and sirukumab [Plivensia]) can play an important role in treating RA.

The importance of this new review lies in its conclusion that IL-6 not only plays a role in the way in which RA develops, but that it also contributes to what the authors referred to as the “secondary characteristics” of RA — pain, mood, and fatigue. As a result, they wrote, physicians who prescribe IL-6 inhibitors for their patients might want to advise them that the medications can not only help with pain, but with other problems as well.

Want to learn more about rheumatoid arthritis? Read “Steps to Manage Rheumatoid Arthritis Flare-Ups” and “Managing Sleep Problems in RA.”

Joseph Gustaitis is a freelance writer and editor based in the Chicago area.

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