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IL-6 Inhibitor Comparison — SCE Rheumatology MCQ

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EasyRheumatology PharmacologyIL-6 Inhibitor ComparisonSCE Rheumatology

A 62-year-old woman with rheumatoid arthritis that remains active despite methotrexate is being considered for sarilumab. Which statement correctly compares sarilumab with tocilizumab in terms of target and UK-licensed routes of administration for rheumatoid arthritis?

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Correct answer: A — Both inhibit IL-6 receptors; sarilumab is subcutaneous, whereas tocilizumab has intravenous and subcutaneous formulations.

Sarilumab and tocilizumab are monoclonal antibodies that inhibit signalling through soluble and membrane-bound IL-6 receptors. The relevant practical distinction is formulation: sarilumab is licensed for subcutaneous administration, while tocilizumab has both subcutaneous and intravenous formulations for rheumatoid arthritis. Neither drug is oral. Tocilizumab does not directly inhibit Janus kinases, although IL-6 receptor signalling acts through the JAK–STAT pathway, and sarilumab does not target IL-1. Option D reverses the licensed formulation distinction. Both agents share important class effects, including infection risk, suppression of acute-phase markers, neutropenia, transaminase elevation and lipid changes, but their safety profiles are not literally identical.

Reference: Electronic Medicines Compendium. Kevzara 200 mg solution for injection SmPC, sections 4.2 and 5.1, revised 2025, https://www.medicines.org.uk/emc/product/15436/smpc; RoActemra subcutaneous and intravenous SmPCs, sections 4.2 and 5.1, revised 2026, https://www.medicines.org.uk/emc/product/5357/smpc and https://www.medicines.org.uk/emc/product/6673/smpc