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Rilonacept in cryopyrin-associated periodic syndromes: the beginning of longer-acting interleukin-1 antagonism

Nature Clinical Practice Rheumatology volume 5, pages 14–15 (2009)Cite this article

Abstract

The remarkable effectiveness of interleukin (IL)-1β blockade in treating the cryopyrin-associated periodic syndromes (CAPS), which present with unexplained fevers and severe localized inflammation, has provided strong evidence for a direct role of IL-1β in the pathogenesis of these diseases. Since 2003, patients with CAPS have been treated with anakinra, a recombinant nonglycosylated human IL-1 receptor antagonist. The short half-life of anakinra, however, necessitates daily injections; therefore, new IL-1β antagonists with longer half-lives, such as the fusion protein rilonacept (IL-1 Trap), have been developed. In an open-label pilot study of rilonacept, five patients with CAPS showed sustained responses and the agent was well tolerated, whilst a phase III clinical study in a large number of patients demonstrated the drug's safety and clinical efficacy. Rilonacept is the first therapy approved by the FDA for the treatment of CAPS and offers a new alternative to anakinra. Further trials are necessary to assess the long-term safety and efficacy of rilonacept.

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Authors and Affiliations

  1. LD Church is a Postdoctoral Research Fellow in the Department of Rheumatology, Division of Immunity, Infection and Inflammation, Institute for Biomedical Research, University of Birmingham, Birmingham, and,

    Leigh D Church

  2. MF McDermott is a Professor of Rheumatology in the Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.,

    Michael F McDermott

Authors
  1. Leigh D Church
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  2. Michael F McDermott
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Correspondence to Michael F McDermott.

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The authors declare no competing financial interests.

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Church, L., McDermott, M. Rilonacept in cryopyrin-associated periodic syndromes: the beginning of longer-acting interleukin-1 antagonism. Nat Rev Rheumatol 5, 14–15 (2009). https://doi.org/10.1038/ncprheum0959

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