An anti-IL-1-beta antibody for periodic fever syndromes and gout flares
Canakinumab
A specialist injected antibody that blocks an inflammation signal, used for periodic fever syndromes, Still's disease and some gout flares.
What is Canakinumab?
Canakinumab is a specialist biological medicine that blocks a natural inflammation signal called interleukin-1 beta (IL-1-beta). It is used for certain rare inherited periodic fever syndromes, for Still's disease (a type of inflammatory arthritis), and in some situations for severe gout flares when usual treatments cannot be used. It is given as an injection under the skin. The most important risk is a greater chance of serious infections, so people are screened for infections including tuberculosis before starting and watched closely afterwards. Live vaccines should be avoided while using it.
Education and reference only. This is a plain-language guide to Canakinumab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Canakinumab is a biological medicine, a type of antibody, that targets and blocks interleukin-1 beta (IL-1-beta), a chemical messenger the body uses to drive inflammation. It is used by specialists to treat several uncommon conditions where this signal is overactive: rare inherited periodic fever syndromes that cause recurring fevers and inflammation, Still's disease (an inflammatory arthritis), and, in selected cases, severe gout flares where standard treatments are unsuitable. It is given as an injection under the skin and is prescribed and supervised by a specialist team because of its effects on the immune system.
How it works
In the conditions it treats, the body produces too much interleukin-1 beta, a signal that switches on inflammation, causing fevers, joint pain, swelling and other symptoms. Canakinumab attaches to IL-1-beta and stops it working, calming the excess inflammation and reducing flares and symptoms. Because it damps down part of the immune system, it also lowers the body's defences against some infections, which is the trade-off that explains its main risk. It is given as an injection at intervals set by the specialist, working over time rather than as a one-off.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist biological medicine used in the UK for certain rare periodic fever syndromes, Still's disease and, in some situations, severe gout flares.
What it treats
Conditions Canakinumab is used for
Practical use
How to take Canakinumab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Use it as an injection under the skin on the schedule your specialist team sets, after being shown how if you inject it yourself.
- Make sure you have been screened for infections, including tuberculosis, before starting.
- Report any signs of infection, such as fever, cough, sore throat or feeling unwell, to your team straight away.
- Avoid live vaccines while using it, and plan any needed vaccinations with your team in advance.
- Keep your regular appointments so your treatment can be reviewed and monitored.
Weighing it up
Advantages & disadvantages of Canakinumab
Advantages
- Effectively calms inflammation in rare periodic fever syndromes, Still's disease and some severe gout flares.
- Given as an injection under the skin at intervals, rather than daily tablets.
- Can greatly reduce flares and symptoms when other treatments have not worked or cannot be used.
Disadvantages
- Increases the risk of serious infections, so careful screening and monitoring are needed.
- Live vaccines must be avoided while using it.
- Commonly causes injection-site reactions and requires specialist supervision.
Practical use
Good to know
The single most important thing to understand about canakinumab is that, by calming the immune system, it raises the risk of serious infections. Before starting, people are screened for existing infections, including hidden (latent) tuberculosis, and treatment is delayed if an active infection is present. While using it, any signs of infection such as fever, cough or feeling generally unwell should be reported promptly. Injection-site reactions, such as redness, swelling or discomfort where the injection is given, are common and usually settle. Live vaccines should not be given while on canakinumab because the weakened immune response can make them unsafe, so vaccinations are planned in advance where possible. It is a specialist treatment with regular review to check it is working and to watch for side effects.
Who should not take it / use with caution
- People with an active, serious infection should not start it until the infection is treated.
- People who have had a serious allergic reaction to canakinumab should not use it.
- It is used with caution, and with screening, in people who have had tuberculosis or are at risk of it.
- Its use in pregnancy and breastfeeding is decided by the specialist, weighing benefits and risks.
Monitoring
- Screening for infections, including tuberculosis, before starting and watching for infections during treatment.
- Reviewing how well flares and symptoms are controlled.
- Checking blood tests, such as white-cell counts, as advised by the specialist.
Side effects
- Injection-site reactions such as redness, swelling or discomfort.
- A higher chance of infections, including coughs, colds and urine or chest infections.
- Headache, nausea or feeling generally tired in some people.
- Rarely, serious infections or allergic reactions, which need urgent medical attention.
Key interactions
- Live vaccines should not be given while using canakinumab because of the weakened immune response.
- Using it with other medicines that suppress the immune system, such as other biologics, can further increase infection risk.
- Tell your team about all your medicines, and mention canakinumab to anyone planning vaccinations or surgery for you.
Available as: A solution, or a powder made up into a solution, for injection under the skin.
Answers
Canakinumab: frequently asked questions
What is canakinumab used for?
It is a specialist injection used for certain rare inherited periodic fever syndromes, Still's disease, and in some situations severe gout flares, by blocking an inflammation signal called interleukin-1 beta.
Why does it increase infection risk?
It calms part of the immune system, which lowers the body's defences against some infections, so people are screened beforehand and watched closely afterwards.
Why am I screened for tuberculosis first?
Because the medicine can let a hidden (latent) tuberculosis infection become active, so it is important to check for and treat it before starting.
Can I have my usual vaccines?
Live vaccines should be avoided while using canakinumab; other vaccines may be possible, so plan any vaccinations with your specialist team in advance.
What are the most common side effects?
Reactions where the injection is given and a higher chance of infections are the most common; report any signs of infection promptly.
The wider class
About Interleukin (IL-1) inhibitor biologic
Canakinumab belongs to the interleukin (il-1) inhibitor biologic class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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