Anakinra

IL-1 receptor antagonist

Response rate
Sustained efficacy up to 5 years
Onset
Hours–days
Route
SC 1-5 mg/kg/day
Line
1st
IgM effect
Normalized within days

Evidence summary

Recombinant IL-1 receptor antagonist blocking both IL-1α and IL-1β. First IL-1 blocker proven effective in CAPS (MWS 2003, NOMID 2006). FDA-approved for NOMID; EMA-approved for all CAPS. Requires daily injection. Short half-life allows rapid dose titration. Injection site reactions in up to 70% but generally manageable.

Molecular targets (2)

MoleculeRoleExpressionEvidence
IL-1βPro-inflammatory cytokineelevatedestablished
IL-1αAlarmin cytokineelevatedstrong

Sources (4)

G1Goldbach-Mansky R et al. (2006) Neonatal-onset multisystem inflammatory disease responsive to interleukin-1β inhibition · N Engl J MedPubMed
G2Sibley CH et al. (2012) Sustained response and prevention of damage progression in patients with NOMID treated with anakinra: 3- and 5-year outcomes · Arthritis RheumPubMed
G3Kullenberg T et al. (2016) Long-term safety profile of anakinra in patients with severe cryopyrin-associated periodic syndromes · RheumatologyPubMed
G5Hawkins PN et al. (2003) Interleukin-1-receptor antagonist in the Muckle-Wells syndrome · N Engl J MedPubMed