Canakinumab

Drugs from the group of human monoclonal antibodies. Canakinumab is used as an immunosuppressant and interleukin inhibitor in various inflammatory diseases. Canakinumab is administered subcutaneously or intravenously.

Canakinumab specifically inhibits the activity of interleukin-1 beta (IL1 beta), thereby inhibiting the inflammatory processes. Due to its specificity, Canakinumab does not trigger a cross-reaction with other interleukin-1 types, such as IL-1 alpha.

In inflammatory diseases, the pathological production of interleukin-1beta leads to local or systemic inflammation and to increased production of "acute phase proteins" such as C-reactive protein (CRP) or serum amyloid A (SAA). Canakinumab binds with high affinity to human IL1 beta in the long term, thereby preventing the interaction of this cytokine with its receptor.

Muckle-Wells syndrome (MWS )

Familial cold urticaria

CINCA syndrome

Mevalonaciduria

Familial Mediterranean fever (FMF): Patients with FMF in whom conventional therapy is contraindicated or not tolerated or in whom no adequate response is achieved despite administration of the highest tolerated dose (Alghamdi M 2017)

Juvenile idiopathic arthritis (SJIA). Canakinumab can be administered as monotherapy or in combination with methotrexate (Hoy SM (2015).

Canakinumab is approved in the EU for patients with gout who do not respond to conventional therapies (colchicine, NSAIDs, glucocorticoids) (Khanna PP et al. 2014)

Pyoderma gangraenosum: The (high) efficacy of canakinumab for pyoderma gangraenosum was demonstrated in a small study. In particular, patients with concomitant bowel disease appear to benefit. (Partridge ACR et al. 2018).

Experimental: Canakinumab was able to reduce the risk of major adverse cardiovascular events (MACE), as demonstrated in a larger study.

There is insufficient experience about the effects of therapy with Canakinumab in pregnancy and breastfeeding. Women of childbearing age should use a reliable method of contraception during and at least 3 months after treatment with Canakinumab.

• Swindle
• local skin reactions at the injection site: redness, swelling, itching
• Nasopharyngitis
• Infections of the upper respiratory tract
• Urinary tract infections

Interactions of Canakinumab with other drugs have not been observed. Canakinumab is regularly given alone or in combination with other basic therapeutic agents such as methotrexate in SJIA and adult breastfeeding syndrome. In cases of Familial Mediterranean Fever (FMF) it should be administered in combination with colchicine if necessary.

• Hypersensitivity to the active substance
• active serious infections
• Pregnancy

Ilaris®

1. Alghamdi M (2017) Familial Mediterranean fever, review of the literature. Clin Rheumatol 36:1707-1713.https://www.ncbi.nlm.nih.gov/pubmed/28624931
2. Hoy SM (2015) Canakinumab: a review of its use in the management of systemic juvenile idiopathic arthritis. BioDrugs 29:133-142.
3. Khanna PP et al (2014) Treatment of acute gout: a systematic review. Semin Arthritis Rheum 44:31-38.
4. Ozdogan H et al (2017) Canakinumab for the treatment of familial Mediterranean fever. Expert Rev Clin Immunol 13:393-404.
5. Orrock JE et al. (2016) Canakinumab for the treatment of active systemic juvenile idiopathic arthritis Expert Rev Clin Pharmacol 9:1015-1024.
6. Partridge ACR et al (2018) Effectiveness of systemic treatments for pyoderma gangrenosum: a systematic review of observational studies and clinical trials. Br J Dermatol 179:290-295.