canakinumab

Canakinumab is a human monoclonal antibody that targets interleukin-1 beta (IL-1β), a cytokine involved in inflammatory signaling. By binding IL-1β, canakinumab prevents activation of the IL-1 receptor, reducing inflammatory responses. It is a selective IL-1β inhibitor and does not directly block IL-1α.

Canakinumab is approved for several autoinflammatory conditions driven by IL-1β signaling. Notably, it is indicated for cryopyrin-associated periodic syndromes (CAPS), a spectrum of disorders caused by NLRP3 mutations, as well as for systemic juvenile idiopathic arthritis (SJIA) and adult-onset Still’s disease (AOSD). Its use in other IL-1–mediated diseases has been explored in clinical trials and clinical practice, but approvals are condition-specific and vary by region.

The drug is administered by subcutaneous injection. Dosing is typically weight-based and scheduled at regular intervals, often monthly for CAPS and SJIA/AOSD, with adjustments guided by disease activity and patient response. In clinical use, physicians tailor intervals and doses to balance disease control with tolerability.

Common adverse effects include infections of the upper respiratory tract, headaches, abdominal pain, and injection-site reactions. Serious infections, neutropenia, and limitations related to immune modulation have been reported, underscoring the need for monitoring. Canakinumab is generally reserved for patients with standard indications when other treatments are unsuitable or ineffective, and its use is guided by regulatory approvals and clinical guidelines.