AUTHOR=Vitale Antonio , Caggiano Valeria , Sbalchiero Jessica , Lopalco Giuseppe , Tufan Abdurrahman , Ragab Gaafar , Sfikakis Petros P. , Dagna Lorenzo , Batu Ezgi Deniz , Ozen Seza , Conti Fabrizio , Maiolini Federica , Bugatti Serena , Frassi Micol , Ruscitti Piero , Morrone Maria , La Torre Francesco , Cakir Ibrahim Yahya , Akay Nergis , Kilic Konte Elif , Laskari Katerina , Bilginer Yelda , Gattamelata Angelica , Croce Jacopo , De Stefano Ludovico , Voltarel Giulia , Cipriani Paola , Maggio Maria Cristina , Al-Mayouf Sulaiman M. , Fotis Lampros , Rigante Donato , Sota Jurgen , Verrecchia Elena , Guggino Giuliana , La Barbera Lidia , Piga Matteo , Emmi Giacomo , Gallizzi Romina , Conti Giovanni , Sfriso Paolo , Bartoloni Elena , Giacomelli Roberto , Barone Patrizia , Olivieri Alma Nunzia , Alemanno Annachiara , Lo Gullo Alberto , Direskeneli Haner , Alibaz-Oner Fatma , Karamanakos Anastasios , Prete Marcella , Edrees Amr , Gavioli Francesco , Parronchi Paola , Ciccia Francesco , Cardamone Chiara , Hernández-Rodríguez José , Hatemi Gülen , Bes Cemal , Almaghlouth Ibrahim A. , Marhuenda Ángel Robles , Gonzáles-García Andrés , Gaggiano Carla , De Paulis Amato , Tezcan Mehmet Engin , Brucato Antonio Luca , Feist Eugen , Tornero-Romero Fernando , Suzon Benoit , Ogunjimi Benson , Thabet Maissa , Conforti Alessandro , Pucino Valentina , Boyarchuk Oksana , Kovalchuk Tetiana , Govoni Marcello , Iagnocco Annamaria , Chimenti Maria Sole , Moshrif Abdelhfeez , Del Giudice Emanuela , Carubbi Francesco , Erten Şükran , Tharwat Samar , Hegazy Mohamed Tharwat , Więsik-Szewczyk Ewa , Torres-Ruiz Jiram , Martín-Nares Eduardo , Balistreri Albert , Fabiani Claudia , Frediani Bruno , Hinojosa-Azaola Andrea , Kasapçopur Özgür , Cantarini Luca 
  
TITLE=Association between canakinumab dose and long-term remission in Still’s disease: insights from the AIDA network registry
  
JOURNAL=Frontiers in Pharmacology
  
VOLUME=Volume 17 - 2026
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1846937
  
DOI=10.3389/fphar.2026.1846937
  
ISSN=1663-9812
  
ABSTRACT=ObjectiveThe primary aim of this study was to assess, in Still’s disease, whether the employment of canakinumab at a strictly on-label dose may increase the likelihood of treatment discontinuation due to study-defined long-term remission (LTR), compared with patients receiving lower doses.MethodsPatients were drawn from the international Autoinflammatory Disease Alliance (AIDA) Network registry dedicated to Still’s disease and stratified based on the starting canakinumab dose: the on-label group received either 300 mg every 4 weeks or 150 mg every 4 weeks (corresponding to 4 mg/kg), while the underdosed group received 150 mg every 4 weeks (corresponding to a dose not exceeding 3.5 mg/kg). Bayesian regression models were implemented to estimate the probability of achieving long-term remission with subsequent canakinumab withdrawal in the two groups, as well as the mean differences in probabilities and posterior probabilities indicating whether the on-label group was superior in achieving the endpoint.ResultsIn total, 131 patients (16.7%) were enrolled, 81 (61.8%) receiving the on-label posology and 50 (38.2%) the underdosed posology. The estimated marginal posterior probability of canakinumab discontinuation due to LTR was 19% (CrI 7.5%–34.6%) in the on-label group and 3.9% (CrI 0.7%–15.2%) in the underdosed group, yielding a mean difference of 15.1% (CrI 1.4%–31.4%) and a posterior probability of 98.4%. This difference remained credible, with posterior probabilities ranging from 97.9% to 99.6%, irrespective of disease course or age at disease onset.ConclusionOn-label canakinumab dosing appears to increase the likelihood of study-defined LTR with subsequent treatment discontinuation, compared with underdosed treatment strategies.