Anakinra
IL-1 receptor antagonist
- Response rate
- ~80-90%
- Onset
- Hours to days
- Route
- SC 100 mg daily
- Line
- 2nd
- IgM effect
- Rapid ferritin reduction
Evidence summary
Recombinant IL-1 receptor antagonist with rapid onset of action. Fever and systemic symptoms often resolve within hours to days. The first RCT (Nordstrom et al. 2012) demonstrated greater remission rates vs DMARDs. Long-term retention rate is excellent with cumulative loss-of-efficacy risk of only 3.4% at 12 months and 13.5% at 60 months. EMA-approved for AOSD. Particularly effective for the systemic phenotype. Expert consensus is shifting toward early biologic use to reduce steroid burden.
Molecular targets (1)
| Molecule | Role | Expression | Evidence |
|---|---|---|---|
| IL-1β | Central pro-inflammatory cytokine driving systemic inflammation | Elevated | established |
Sources (4)
DetailsNordstrom D et al. (2012) Beneficial effect of interleukin 1 inhibition with anakinra in adult-onset Still's disease: an open, randomized, multicenter study · J RheumatolPubMed ↗
DetailsVitale A et al. (2019) Long-term retention rate of anakinra in adult onset Still's disease and predictive factors for treatment response · Front PharmacolPubMed ↗