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Club Rhumatismes et Inflammation guidelines for anti-interleukin-1 therapy: 2026 update.

Stéphane Mitrovic1, Marion Delplanque2, Hang-Korng Ea3

  • 1Rheumatology Department, Pitié-Salpêtrière Hospital, AP-HP, Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), FAI2R Rare Diseases Networks, and INSERM UMRS 959, Immunology - Immunopathology - Immunotherapy (i3), Sorbonne University, Paris, France.

Joint Bone Spine
|June 11, 2026
PubMed
Summary
This summary is machine-generated.

Updated guidelines for interleukin-1 (IL-1) inhibitors in autoinflammatory diseases (AIDs) provide practical clinical guidance. These recommendations cover anakinra and canakinumab, addressing various patient scenarios and ensuring optimal efficacy and safety.

Keywords:
IL-1 inhibitorsanakinraanti-IL-1 therapyautoinflammatory diseasesbiological therapiescanakinumabpre-treatment assessment

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Area of Science:

  • Rheumatology and Immunology
  • Pediatric Rheumatology
  • Internal Medicine

Background:

  • Interleukin-1 (IL-1) inhibitors are crucial for managing autoinflammatory diseases (AIDs).
  • The existing Club Rhumatismes et Inflammations (CRI) guidelines for anti-IL-1 therapy were last updated in 2014.
  • An updated guideline is necessary to reflect current scientific data and clinical practice.

Purpose of the Study:

  • To update the Club Rhumatismes et Inflammations (CRI) guidelines for anti-interleukin-1 (IL-1) therapy.
  • To provide evidence-based recommendations for the use of anakinra and canakinumab in AIDs.
  • To offer practical tools for clinicians managing patients on anti-IL-1 agents.

Main Methods:

  • A comprehensive literature review was conducted up to November 2025.
  • Expert consensus was achieved through a multidisciplinary writing group (rheumatologists, internists, pediatricians).
  • Guidelines were systematically reviewed by scientific coordinators.

Main Results:

  • The update focuses on anakinra and canakinumab, the primary anti-IL-1 agents used in Europe.
  • Twenty guideline areas were developed, covering pre-treatment assessment, follow-up, and management of specific conditions and complications.
  • These include infections, malignancies, cardiovascular issues, intolerance, autoimmune conditions, organ dysfunction, and special populations (e.g., low-weight children, pregnant women).

Conclusions:

  • The updated CRI guidelines offer a practical resource for clinicians.
  • They synthesize the latest scientific evidence on the efficacy and safety of anti-IL-1 therapy.
  • These guidelines aim to optimize patient care in various clinical scenarios encountered in AIDs management.