IL1remmers

IL-1 inhibitors are a class of anti-inflammatory drugs that block the signaling of interleukin-1 (IL-1), a cytokine involved in fever and inflammatory responses. They work by neutralizing IL-1 directly, or by inhibiting its interaction with the IL-1 receptor, thereby reducing downstream inflammatory cascades. The IL-1 family includes IL-1 alpha and IL-1 beta, both of which can drive autoinflammatory and autoimmune processes.

The main agents in clinical use are anakinra, canakinumab, and rilonacept. Anakinra is a recombinant IL-1 receptor antagonist that blocks both IL-1 alpha and IL-1 beta by preventing receptor activation. Canakinumab is a monoclonal antibody that selectively binds IL-1 beta. Rilonacept is a fusion protein that acts as a decoy receptor, trapping IL-1 alpha and IL-1 beta in the extracellular space. These drugs are approved for various autoinflammatory conditions, including cryopyrin-associated periodic syndromes (CAPS), familial Mediterranean fever, macrophage activation syndromes, and systemic juvenile idiopathic arthritis, among others, with additional indications in adults such as recurrent pericarditis in certain settings.

Administration is typically by subcutaneous injection, with dosing frequency varying by agent and condition. Anakinra is usually given daily, canakinumab every several weeks, and rilonacept weekly. Dosing is guided by the specific disease, patient response, and tolerability.

Common adverse effects include increased susceptibility to infections, injection-site reactions, and neutropenia in some cases. Safety considerations include monitoring for infection, vaccination status, and potential liver or hematologic abnormalities. IL-1 inhibitors represent a specialized therapeutic option for select inflammatory diseases and are used where IL-1–driven pathology is established or strongly suspected.