Anti-IL6R Therapy Effective in Reducing NMOSD and MOGAD Disease Activity | NeurologyLive
A recently published study in Sage Journals indicates that treatment with anti-interleukin-6 receptor (anti-IL6R) therapy can reduce disease activity in both neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD). The therapy appeared particularly effective in patients who had not responded to previous treatment with rituximab.
New Findings on Autoimmune Disease Treatment
The research, led by Nicolas Collongues, MD, PhD, professor and neurologist at Strasbourg University Hospitals in France, revealed a significant reduction in annualized relapse rates among patients receiving anti-IL6R therapy. Specifically, relapse rates were notably lower during anti-IL6R exposure compared to the year prior to treatment in individuals with AQP4-positive NMOSD (n = 25, P = 0.007) and MOGAD (n = 15, P = 0.003). Importantly, the study did not find a significant change in Expanded Disability Status Scale (EDSS) scores during the treatment period.
The study involved 51 participants, with anti-IL6R therapy being used as a second-line treatment in over half of the cases (51%). A substantial majority – 62.7% – had previously been treated with rituximab. Researchers also observed higher levels of interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) of patients with MOGAD, but found no correlation between these levels and relapse rates.
Study authors stated their goal was to determine if IL6 levels in the CSF could predict a patient’s response to anti-IL6R therapy. However, they noted that the IL-6 levels were collected before the start of immunosuppressive treatment, typically only at the time of diagnosis, and were not routinely monitored during patient follow-up. They were unable to establish a link between IL-6 levels in CSF and recovery after a relapse.
Study Limitations and Future Research
The authors acknowledged several limitations that could affect the interpretation of the findings. A potential selection bias exists, as all participants ultimately received anti–IL6R therapy. Longer follow-up periods might also be needed, particularly considering the European approval of satralizumab in 2021. Incomplete data, the lack of CD19⁺/CD20⁺ B-cell measurements before initiating anti–IL6R therapy, and limited CSF IL-6 samples further constrained the analysis.
The study authors concluded that their work adds to the growing body of research on IL6 and supports the use of anti-IL6R therapy in reducing disease activity in both NMOSD, and MOGAD. They suggest that more standardized and systematic testing of IL6 in CSF could improve understanding of the underlying mechanisms of these diseases and lead to more personalized treatment approaches.
Frequently Asked Questions
What is anti-IL6R therapy?
Anti-IL6R therapy is a treatment that targets the interleukin-6 receptor, a component of the immune system. The study found it effective in reducing disease activity in NMOSD and MOGAD.
In which conditions was this therapy studied?
The study focused on patients with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD).
Did the study find a link between IL-6 levels and treatment response?
Despite higher IL-6 levels in the CSF of patients with MOGAD, the study did not find a correlation between CSF IL-6 concentrations and relapse rates.
As research continues, it will be important to see if larger studies confirm these findings and identify which patients are most likely to benefit from anti-IL6R therapy. Further investigation into biomarkers like IL-6 could also refine treatment strategies and improve outcomes for individuals living with these challenging autoimmune conditions.