**10. Conclusions**

Recent evidence from both observational studies and clinical trials have clarified the e fficacy of ANA and CANA in the main AIDs, also revealing a good safety profile with minor concerns regarding tolerability. In particular, the major treatment-related side e ffects of ANA are skin reactions at the injection-site. This high rate of injection-site reactions can become so irritating for pediatric patients that they require treatment withdrawal. In this regard, convincing patients, especially children, to continue therapy can be challenging. Reactions can be mitigated by the application of topical hydrocortisone or anti-histamine cream, but it may not be enough [106]. On the other hand, the overall safety of CANA has shown an excellent tolerability [107], as highlighted by very few discontinuation rates and few injection-site reactions. However, a slightly increased rate of non-serious infections related to the upper respiratory tract has been observed [26]. Although these two anti-IL1 agents represent the most effective treatments available in AIDs and also a promising tool in refractory KD, the development of novel pharmacological formulations that further reduce side e ffects in pediatric sceneries is expected.

**Author Contributions:** Conceptualization, A.B., G.L., G.E., L.C., D.R., R.C. and F.I.; Literature review, A.B., M.L.U. and G.L.; Writing—Original Draft Preparation, A.B. and G.L.; Writing—Review & Editing, A.B., G.L., G.E., M.L.U., L.C., A.V. (Antonio Vitale), A.V. (Alfredo Vannacci), N.D., A.L. (Antonio Lopalco), A.C., A.L. (Angela Lopedota), V.V., M.F., D.R., R.C. and F.I.

**Funding:** This research received no external funding.

**Acknowledgments:** We would like to thank Giovanni Lapadula for his valuable insights.

**Conflicts of Interest:** The authors declare no conflict of interest.
