Summary of Clinical Use

Used to treat rheumatic diseases; familial cold autoinflammatory syndrome (FCAS) [4] and Muckle-Wells syndrome (MWS) in patients >4 years of age, systemic juvenile idiopathic arthritis (sJIA) in patients >2 years old [7], and adult-onset Still's disease. Unexpectedly, further analysis of data from the CANTOS cardiovascular disease trial revealed that IL-1β inhibition significantly reduced the incidence of hip and knee replacements compared to those not treated with canakinumab, suggesting application of canakinumab as a large joint osteoarthritis therapeutic [8]. SARS-CoV-2 and COVID-19: Canakinumab has been entered in to clinical trials that aim to determine its ability to combat the exaggerated immune response that drives cytokine storm and leads to tissue damage in the lung and other organs in patients with severe COVID-19.

Mechanism Of Action and Pharmacodynamic Effects

A monoclonal antibody which binds to human IL-1β and neutralizes its inflammatory activity by blocking its interaction with IL-1 receptors [1], but it does not bind IL-1α or IL-1 receptor antagonist (IL-1ra). The patent claiming this antibody, US7446175, reports that the antigenic epitope on IL-1β is the loop containing the Glu64 residue in the mature cytokine (equivalent to residue 180 of the precursor peptide) [3]

Clinical Trials
Clinical Trial ID	Title	Type	Source	Comment	References
NCT01327846	Cardiovascular Risk Reduction Study (Reduction in Recurrent Major CV Disease Events)	Phase 3 Interventional	Novartis	Results from the CANTOS trial (NCT01327846) showed that canakinumab (in high-risk patients; in addition to standard-of-care therapy) reduced the number of recurrent cardiovascular events that were recorded at 3-4 years follow-up	2
NCT04365153	Canakinumab in Covid-19 Cardiac Injury (The Three C Study)	Phase 2 Interventional	The Cleveland Clinic
NCT04362813	Study of Efficacy and Safety of Canakinumab Treatment for CRS in Participants With COVID-19-induced Pneumonia	Phase 3 Interventional	Novartis

External links

For extended ADME data see the following: Electronic Medicines Compendium (eMC) Drugs.com European Medicines Agency (EMA)