#1-92E. Choosing the Right IL-1 Inhibitor in VEXAS Syndrome: Anakinra vs. Canakinumab (Arthritis & Rheumatology, 2025)

In the management of VEXAS syndrome, IL-1 inhibitors are a promising option, but which one is superior: anakinra or canakinumab? This international multicenter study compared the efficacy and safety of these two agents in patients with VEXAS syndrome. The study found that canakinumab was superior to anakinra across all metrics, including clinical response, drug survival, and safety profile. Notably, canakinumab at a dose of 300 mg/month demonstrated higher efficacy, longer drug survival, and fewer adverse events compared to anakinra, positioning it as a key steroid-sparing option for VEXAS patients. However, as a retrospective study with a small canakinumab cohort of only nine patients, the findings should be interpreted with caution due to the risk of selection bias and unstable estimates.

Citation: EVIATAR, Tali, et al. Comparative efficacy and safety of anakinra and canakinumab in patients with VEXAS syndrome – an international multicenter study. Arthritis & Rheumatology. 2025. DOI: 10.1002/art.43384

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