Arthritis Rheumatol

ACR 2025: Study compares CV outcomes, mortality of IL-6 antagonists in RA

October 29, 2025

This poster, presented at ACR Convergence, reports findings from a multi-center, real-world cohort study comparing the safety of IL-6 inhibitors in rheumatoid arthritis (RA). Using data from the TriNetX Global Network, researchers divided adult RA patients into three cohorts: non-IL6, tocilizumab-only, and sarilumab-only. Over a 5-year follow-up, tocilizumab was associated with higher all-cause mortality than both sarilumab (5.6% vs. 3.7%; hazard rate [HR], 1.61, p=0.001) and non-IL6 regimens (6.4% vs. 5.5%; p<0.001). Sarilumab showed no significant mortality difference compared with non-IL6 therapy. Cardiovascular outcomes (MI, stroke, heart failure, VTE) were similar across groups. Notably, in sex-stratified analyses, mortality was significantly higher in males treated with tocilizumab vs. sarilumab (8.3% vs. 4.8%; HR, 1.86, p=0.049), while no significant difference was seen in females. The findings suggest sarilumab may offer a mortality advantage over tocilizumab, particularly in male patients, and highlight the importance of individualized IL-6 inhibitor selection.

Source:

Sharkas S, et al. “Real-World Comparative Safety of Tocilizumab and Sarilumab in Rheumatoid Arthritis: A Multi-Center Observational Study” [abstract]. Arthritis Rheumatol. Presented at ACR Convergence 2025. https://acrabstracts.org/abstract/real-world-comparative-safety-of-tocilizumab-and-sarilumab-in-rheumatoid-arthritis-a-multi-center-observational-study/. Accessed October 28, 2025.