Anakinra usage in febrile infection related epilepsy syndrome: an international cohort

Ann Clin Transl Neurol. 2020 Dec;7(12):2467-2474. doi: 10.1002/acn3.51229. Epub 2020 Dec 4.


Febrile-infection related epilepsy syndrome (FIRES) is a devastating neurological condition characterized by a febrile illness preceding new onset refractory status epilepticus (NORSE). Increasing evidence suggests innate immune dysfunction as a potential pathological mechanism. We report an international retrospective cohort of 25 children treated with anakinra, a recombinant interleukin-1 receptor antagonist, as an immunomodulator for FIRES. Anakinra was potentially safe with only one child discontinuing therapy due to infection. Earlier anakinra initiation was associated with shorter duration of mechanical ventilation, ICU and hospital length of stay. Our retrospective data lay the groundwork for prospective consensus-driven cohort studies of anakinra in FIRES.

MeSH terms

  • Child
  • Child, Preschool
  • Cohort Studies
  • Epileptic Syndromes / therapy*
  • Humans
  • Infections / therapy*
  • Infectious Encephalitis
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use*
  • Retrospective Studies
  • Seizures, Febrile / therapy*


  • Interleukin 1 Receptor Antagonist Protein