Anakinra desensitisation in patients with cryopyrin-associated periodic syndromes

Cryopyrin-associated periodic syndrome (CAPS) is rare and patients experience rashes, arthralgias and fevers despite supportive treatment. In these cases, anakinra subcutaneous therapy is indicated which provides symptom control. However, adverse reactions notably injection-site related, are common resulting in treatment cessation in these patients. Ongoing symptoms lead to morbidity and predispose patients to complications such as amyloidosis. We describe our experience with anakinra desensitisation in two cases with CAPS who had injection-site related reactions. We also propose a 34-day outpatient desensitisation protocol.