<p>The Efficacy, Safety and Tolerability of Canakinumab in the Treatment of Familial Mediterranean Fever: A Systematic Review of the Literature</p>

Abstract

Familial Mediterranean Fever (FMF) is the most prevalent genetic autoinflammatory disorder. In most patients, treatment with colchicine can prevent attacks of fever and inflammation. However, 5%-10% of patients are resistant to colchicine treatment, while a similar percentage cannot tolerate colchicine in doses needed to prevent attacks. For these patients, Canakinumab, a full human antibody against IL-1β, has been approved recently by the FDA and EMA. In this article, we present a systematic review of the long-term efficacy, safety, and tolerability of Canakinumab in FMF patients who cannot tolerate colchicine or who are resistant to colchicine treatment.

The Rheumatology Drugs for COVID-19 Management: Which and When?

“…Canakinumab is an anti-IL-1 monoclonal antibody totally humanized (the proposed canakinumab dose is 600 mg in 250 mL of 5% dextrose infused intravenously (i.v.) over 2 h), approved for the treatment of the familial Mediterranean fever [ 81 ].…”

“…Specifically, these authors indicate the best time for administration is the moment when the following conditions are observed: reduction of B- and T-cells, increase of inflammatory cytokines such as IL-6, increase of CRP, increase of D-dimer in peripheral blood, and the worsening of the lung imaging on CT. Moreover, they suggest the concomitant use of low-molecular-weight heparin as anticoagulant therapy to counteract the onset of DIC [ 81 ]. Regarding dosage, this group recommends the use of high-dose IVIg (0.3–0.5 g/kg of body weight for five days), as this could interrupt the cytokine-enhanced release at an early stage [ 83 ].…”

Propuesta de uso de anakinra en el distrés respiratorio agudo secundario a COVID-19

“…Constituye así una posible diana terapéutica en aquellos pacientes que tras la infección por COVID-19 pueden progresar hacia el SDRA. El uso de anakinra (anti IL 1␤ R) o canakinumab (anti-IL-1␤) constituyen una opción terapéutica para controlar la inflamación alveolar secundaria a infección por COVID-19 14,15 .…”

“…La concentración sérica máxima (C máx ) de canakinumab se produce aproximadamente a los 7 días tras una administración única de 150 mg por vía subcutánea a pacientes con síndrome periódico asociado a criopirinas (CAPS adultos). La semivida terminal media es de 26 días y los valores medios de concentración plasmástica máxima (C máx ) después de una única dosis subcutánea de 150 mg en un paciente adulto común de CAPS (70 kg) es de15,9 g/ml y una biodisponibilidad absoluta administrado por vía subcutánea del 66% 15 . Anakinra, en cambio tiene una biodisponibilidad absoluta del 95% para adultos sanos después de un bolo de 70 mg de inyección subcutánea.…”

Improvement of liver involvement in familial Mediterranean fever after introduction of canakinumab: a case report

“…Interleukin-1 (IL-1) blockade is considered the gold-standard treatment in refractory FMF, with several reports having demonstrated both efficacy and safety of anakinra and canakinumab. 19 – 22 …”