Experience on the long-term use of canakinumab in mevalonate kinase deficiency: A case series

We really appreciated the article “Long-term efficacy of canaki- numab in hyperimmunoglobulin D syndrome” recently published by your Journal. Indeed, although the treatment has been approved for hyperimmunoglobulin D syndrome (or mevalonate kinase de- ficiency – MKD), scarce data are available from real-world experi- ences. The “cluster” clinical trial for drug approval showed that the response to canakinumab is less predictable in MKD than in other autoinflammatory disorders, and several patients only show a par- tial response. To further describe long-term experience with canaki- numab in MKD, we would like to share our experience on its use at the Rheumatology Service of the Institute for Maternal and Child Health IRCCS Burlo Garofolo Hospital in Trieste, Italy.