Summary

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• Ilaris (canakinumab) is indicated for the treatment of periodic fever syndromes: Cryopyrin-Associated Periodic Syndromes (CAPS) in adults and children 4 years of age and older, including Familial Cold Auto-inflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS); the treatment of periodic fever syndromes: Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPS) in adult and pediatric patients; the treatment of periodic fever syndromes: Hyperimmunoglobulin D Syndrome (HIDS)/Mevalonate Kinase Deficiency (MKD) in adult and pediatric patients; the treatment of periodic fever syndromes: Familial Mediterranean Fever (FMF) in adult and pediatric patients; the treatment of Active Still’s disease, including Adult-Onset Still’s Disease (AOSD) and Systemic Juvenile Idiopathic Arthritis (SJIA) in patients aged 2 years and older; and the treatment of Gout flares in adults in whom non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine are contraindicated, are not tolerated, or do not provide an adequate response, and in whom repeated courses of corticosteroids are not appropriate.
• This summary is based on the review of 16 systematic review(s)/meta-analysis(es). ^[1-16]
• Gout Flares: Canakinumab and rilonacept showed superior effectiveness compared to active comparators in pain resolution and reducing flare frequency, while anakinra was not inferior to active comparators for pain resolution.
• Familial Mediterranean Fever (FMF): Anti-IL-1 agents (canakinumab, anakinra, rilonacept) achieved complete remission in 60% of adult patients and 81% of pediatric patients, along with a significant decrease in inflammatory markers.
• Systemic Juvenile Idiopathic Arthritis (sJIA): Canakinumab demonstrated the highest probability of achieving the best treatment response (modified ACRpedi30), followed by anakinra, tocilizumab, and rilonacept.
• Adult-Onset Still's Disease (AOSD): Canakinumab led to complete remission in 68.7% of patients, partial improvement in 16.2%, and no clinical improvement in 15.1%.
• Gout Flares: Canakinumab, anakinra, and rilonacept were mostly well-tolerated, with no significant differences in the incidence of serious adverse events reported.
• FMF: Adverse events occurred in 25% of adult patients and 12% of pediatric patients treated with anti-IL-1 agents.
• AOSD: Canakinumab treatment was associated with 210 adverse events, the most common being respiratory tract infections. Severe adverse events included macrophage activation syndrome and serious infections.
• Population Types and Subgroup Considerations: Pediatric patients with Familial Mediterranean Fever (FMF) had higher remission rates (81%) compared to adults (60%); patients with Adult-Onset Still's Disease (AOSD) varied in disease severity and previous treatments; for Schnitzler Syndrome, patients varied but subgroup specifics were not detailed; systemic Juvenile Idiopathic Arthritis (sJIA) studies included both pediatric and adult populations, but specific subgroup details were not provided.