Based on the patient’s history of asbestos exposure, clinical, laboratory and instrumental investigations, a diagnosis of mild asbestosis with prominent asbestos-induced systemic autoimmune disease features was made, and, considering the contraindication to corticosteroid use due to the severe osteoporotic vertebral fractures, and the recent data reported in the literature showing a pathogenic role of IL-1 beta in pneumoconiosis, subcutaneous canakinumab at a dose of 150 mg every 8 weeks was proposed. Here, IL1B is linked to asbestosis.