Diagnosis: Relapsing fever
Treatment: Kineret
The treatment with Kineret is medically necessary.

The patient is a female with a history of undifferentiated Systemic Autoinflammatory Disease (uSAID). She has symptoms including fevers, rashes and delayed development. Her pediatric rheumatology provider has written to start anakinra to treat her uSAID.

The reason given for denying the medication was that anakinra does not have a FDA approved indication to treat uSAID. Despite this, anakinra has been used safely and effectively to treat similar patients with this condition (see references #1-5 below). Treatment with anakinra would be considered standard of care in the pediatric rheumatology community for patients with uSAID. Therefore, approval of anakinra is recommended for this patient with uSAID for a duration of 24 months.