Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack.

Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. A common adverse reaction of canakinumab that can be confused with symptoms of an acute porphyric attack is abdominal pain.

Antibody preparation with no CYP metabolism. Based on the pharmacokinetics, canakinumab is not expected to have any porphyrinogenic effects.

Canakinumab is a fully human monoclonal antibody against interleukin 1-beta produced in murine cells by recombinant DNA technology

Canakinumab is used in the treatment of Cryopyrin-Associated Periodic Syndromes (CAPS). It is administered as a subcutaneous injection.

The metabolism of canakinumab is expected to be similar as for endogenous antibodies, which are metabolised to peptides and amino acids in various body tissues and in plasma by circulating phagocytic cells or by their target antigen-containing cells. Immunosuppressive treatment can reverse the down regulation of the expression of CYP enzymes (CYP 3A4, 1A2, 2C9 or 2C19) caused by inflammatory cytokines. This effect is not suspected to be porphyrinogenic as the CYP enzyme activity is not induced above a normal level.