Canakinumab

Anti-IL-1beta monoclonal antibody

Response rate
67.5% complete response
Onset
Days-weeks
Route
SC 150mg every 4-8 weeks
Line
2nd
IgM effect
Normalises SAA/CRP

Evidence summary

FDA and EMA approved for FMF. Longer dosing interval than anakinra (every 4-8 weeks vs daily). Reduced attacks from 8.3 to 1.56 per 24 weeks (P<0.001) in one cohort. Effective after colchicine and/or anakinra failure. Preferred by 72.2% of clinicians for colchicine-resistant FMF in multinational survey.

Molecular targets (1)

MoleculeRoleExpressionEvidence
IL-1βCentral effector cytokineElevatedestablished

Sources (4)

Detailsvan der Hilst JCH et al. (2016) Efficacy of anti-IL-1 treatment in familial Mediterranean fever: a systematic review of the literature · BiologicsPubMed
DetailsGrattagliano V et al. (2023) Efficacy and safety of anti-interleukin-1 treatment in familial Mediterranean fever patients: a systematic review and meta-analysis · Clin Exp RheumatolPubMed
DetailsCetin P et al. (2021) Canakinumab is effective in patients with familial Mediterranean fever resistant and intolerant to colchicine and/or anakinra treatment · Int J Rheum DisPubMed
DetailsOzen S et al. (2025) EULAR/PReS endorsed recommendations for the management of familial Mediterranean fever (FMF): 2024 update · Ann Rheum DisDOI