Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report - Summary - MDSpire

Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report

  • By

  • Zhang, Lijun

  • Li, Deyuan

  • Wang, Jianjun

  • Wang, Xiao

  • Zhao, Wanling

  • Lu, Guoyan

  • June 1, 2026

  • 0 min

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Objective:

To report the effectiveness of anakinra in a case of FIRES resistant to tocilizumab despite normal IL-1β levels.

Approach:
    Key Findings:
    • The patient had elevated IL-6 but normal IL-1β levels.
    • Anakinra was effective in controlling seizures after tocilizumab failure.
    • The patient had rare brief seizures at one-month follow-up and returned to school.
    Interpretation:

    Anakinra may be a viable second-line treatment for FIRES resistant to tocilizumab, even with normal IL-1β levels.

    Limitations:
    • This is a single case report, limiting generalizability.
    • Further studies are needed to establish broader efficacy and safety.
    Conclusion:

    Anakinra should be considered as a second-line option in selected FIRES patients, regardless of IL-1β biomarker status.

Original Source(s)

Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report

  • by Zhang, Lijun , Li, Deyuan , Wang, Jianjun , Wang, Xiao , Zhao, Wanling , Lu, Guoyan

  • June 1, 2026

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