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[Comment] Interleukin-6 inhibition for rheumatoid arthritis

In The Lancet, Daniel Aletaha and colleagues1 report the results of their phase 3, double-blind, placebo-controlled study (SIRROUND-T) of two doses of sirukumab, a human monoclonal antibody that binds to the interleukin 6 cytokine, compared with placebo in patients with active rheumatoid arthritis who were refractory or intolerant to anti-tumour necrosis factor (TNF) agents. The patient population was unusual; approximately 20% of the participants were not receiving concomitant conventional disease modifying antirheumatic drugs (DMARDs) at baseline, and participants could have been refractory to several biological DMARDs including tocilizumab.