Canakinumab (Ilaris)

Canakinumab (Ilaris) is covered only for FDA‑approved indications—CAPS (FCAS or MWS) in patients ≥4 years, TRAPS, HIDS/MKD, FMF, and active sJIA in patients ≥2 years—and off‑label uses are not covered. Approval requires no active/chronic infection, no concomitant TNF‑inhibitor, adherence to indication‑specific prior‑therapy/response criteria (notably sJIA initial criteria), weight‑based dosing per policy with justification for dose escalation, documentation of diagnosis/weight/prior therapies/no TNF use, and authorizations are time‑limited to 12 months (renewal requires improvement or stability).

"Ilaris is indicated for the treatment of Cryopyrin-Associated Periodic Syndromes (CAPS), in adults and children 4 years of age and older including: Familial Cold-Autoinflammatory Syndrome (FCAS); M..."

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