Canakinumab

Anti-IL-1β monoclonal antibody

Response rate
45% complete (Phase III); >94% disease control (long-term)
Onset
Days–weeks
Route
SC 150mg every 4–8 weeks
Line
1st
IgM effect
N/A

Evidence summary

Selectively neutralises IL-1β with a long half-life allowing monthly dosing. The CLUSTER Phase III RCT (De Benedetti 2018) showed 45% complete response vs 8% placebo in TRAPS. The 72-week extension demonstrated >94% achieving no/minimal disease activity with sustained treatment. FDA/EMA approved for TRAPS. No patients on canakinumab developed AA amyloidosis in the Eurofever registry.

Molecular targets (1)

MoleculeRoleExpressionEvidence
IL-1βKey effector cytokineElevatedestablished