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Pediatric Rheumatology

Open Access

Canakinumab in the routinary clinical practice in cryopyrin-associated periodic syndromes (CAPS): one year of follow-up

  • R Caorsi1,
  • L Lepore2,
  • F Zulian3,
  • M Alessio4,
  • A Stabile5,
  • M Finetti1,
  • A Martini1 and
  • M Gattorno1
Pediatric Rheumatology20119(Suppl 1):P22

Published: 14 September 2011


Pediatric PatientClinical ManifestationAcute PhaseOptimal DosageInitial Dosage


No clear information on the optimal dosage of Canakinumab in CAPS is available.


To analyse the modification of dosage schedule of Canakinumab in CAPS in 12 months of routinely clinical practice.


12 patients (9 children and 3 adults) with Muckle-Wells syndrome (3), MWS/CINCA overlap (3) and CINCA (6) were analyzed. Patients were previously enrolled in the CACZ885D2306 trial and studied for the following 12 months.


At baseline, 7 patients were treated with the initial dosage of 2 mg/kg (or 150 mg, if > 40 Kg) every 8 weeks. In 5 patients (2 MWS/CINCA overlap, 5 CINCA) the dosage was 4 mg/kg (or 300 mg) every 8 weeks.

During the following 12 months modification of dosage of frequency was performed in 7/12 patients. The 5 patients at higher dosage during the CACZ885D2306 study needed to increase the frequency of administration with a mean frequency of 6 weeks (range 4-8). The mean reason was the presence of mild clinical manifestation and/or persistent elevation of acute phase reactants. In one of these patients the therapy was subsequently discontinued due to persistent disease activity. An increased frequency (6 and 7 weeks) was also performed in 1 MWS and 1 CINCA patient, respectively.

In 5 patients the treatment was not modified being effective in the control of the disease.


This study confirms the efficacy of Canakinumab in CAPS. However, pediatric patients and those with a more severe phenotype require higher and more frequent dosage than previously described.

Authors’ Affiliations

UO Pediatria II, G. Gaslini Institute and Department of Pediatrics, University of Genoa, Genova, Italy
IRCCS Burlo Garofalo, Dipartimento di Pediatria, University of Trieste, Trieste, Italy
Dipartimento A.I. di Pediatria, University of Padua, Padova, Italy
Department of Pediatrics, Federico II Hospital, Napoli, Italy
Department of Paediatrics, A. Gemelli Hospital, University of Rome, Italy


© Caorsi et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.