Canakinumab for the treatment of different refractory autoinflammatory disorders

Introduction Interleukin-1b (IL-1b) is a powerful pro-inflammatory cytokine synthesized in the inflammasome complex of immune cells in response to injury and infection. The excess activity of this cytokine plays a fundamental role in the pathogenesis of the autoinflammatory disorders. An emphasis on pediatric rheumatology is given to systemiconset juvenile idiopathic arthritis (SoJIA) and periodic fever syndromes. Until the last decade, there wasnt an efficient alternative for the treatment of autoinflammatory syndromes refractory for convencional therapies. This scenery was modified with the introduction of biological agents, especially the IL-1 antagonist group (Anakinra, Rilonacept and Canakinumab). Canakinumab, a fully human anti-IL-1b monoclonal antibody, selectively binds to IL-1b, and intercepts the spread of inflammation. This medication was approved for treatment of cryopyrinassociated periodic syndrome (CAPS) in 2009, and SoJIA in 2013, and has shown to be an excellent tool for controlling these disorders.