Recently, recombinant human IL-18BP or called Tadekinig Alfa has been used for a phase II clinical trial in Europe to treat adult onset Still’s disease patients24 and a phase III clinical trial with the experimental drug IL-18BP in patients carrying a mutation of the NOD-like receptor C4 (NLRC4) gene characterized by severe, life threatening systemic inflammation associated with extremely high levels of IL-18 (https://www.ab2bio.com). This evidence concerns the gene NLRC4 and adult-onset Still disease.