Canakinumab
Anti-IL-1beta monoclonal antibody
- Response rate
- ~67%
- Onset
- Days to weeks
- Route
- SC 150-300 mg every 4 weeks
- Line
- 2nd
- IgM effect
- Rapid ferritin reduction
Evidence summary
Long-acting anti-IL-1beta monoclonal antibody. The CONSIDER phase II RCT showed 67% response (vs 41% placebo). Received EMA conditional marketing authorization for Still's disease (including AOSD) in 2020. FDA approved canakinumab for sJIA in 2013 but has not granted a separate AOSD indication. Advantage over anakinra is less frequent dosing (monthly vs daily). Effective for both systemic and articular manifestations.
Molecular targets (1)
| Molecule | Role | Expression | Evidence |
|---|---|---|---|
| IL-1β | Central pro-inflammatory cytokine driving systemic inflammation | Elevated | established |