Summary

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• This summary is based on the review of 13 systematic review(s)/meta-analysis(es). ^[1-13]
• In adult-onset Still's disease (AOSD), canakinumab achieved complete remission in 68.7% of 99 patients and showed a complete remission rate of 77% (95% confidence interval (CI) 29-97%) with corticosteroid discontinuation in 34% (95% CI 6-81%), while effectiveness and safety were reported in refractory cases.
• For Gout Flares, canakinumab and rilonacept effectively reduced flare frequency and pain, with canakinumab providing the highest pain reduction by day 2 and at follow-up, outperforming corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs).
• In Familial Mediterranean Fever (FMF), canakinumab was effective in 60% of adult patients and 81% of pediatric patients and likely reduced attack frequency in colchicine-resistant cases by 16 weeks.
• Cryopyrin-Associated Periodic Syndromes (CAPS) patients responded positively to canakinumab and other interleukin (IL)-1 blockers, with studies indicating effectiveness across IL-1 inhibitor options.
• AOSD: Among 69 patients treated with IL-1 inhibitors, 210 adverse events were reported, with respiratory tract infections, arthralgia, disease flares, abdominal pain, nausea, and diarrhea being common. Severe adverse events included macrophage activation syndrome and serious infections.
• Gout Flares: IL-1 inhibitors (canakinumab, anakinra, rilonacept) were mostly well-tolerated, with moderate certainty evidence suggesting canakinumab may have a superior safety profile compared to corticosteroids and NSAIDs.
• FMF: Adverse events occurred in 25% of adult patients and 12% of pediatric patients treated with canakinumab, with fewer serious adverse events compared to placebo in colchicine-resistant cases. Injection-site reactions were frequently observed for anakinra, rilonacept, and etanercept.
• Canakinumab demonstrated effectiveness across various populations, including adult and pediatric patients with conditions like AOSD, gout flares, FMF (with greater efficacy in pediatric FMF patients), and CAPS; IL-1 blockade during pregnancy showed no increase in adverse perinatal outcomes.