anakinra (Kineret)

Anakinra (Kineret) is a synthetic (man-made), injectable, interleukin-1 (IL-1) receptor antagonist that blocks the effects of human interleukin-1. It is used in the treatment of rheumatoid arthritis.

Is anakinra available as a generic drug?

No

Anakinra is used for treating the signs and symptoms of moderate to severe rheumatoid arthritis in individuals 18 years of age or older. It is not a first-line drug but is used in individuals who have failed at least one of the other disease-modifying drugs that are used to treat rheumatoid arthritis. It can be used alone or in combination with other agents, but it should not be used with drugs that block tumor necrosis factor alpha such as infliximab (Enbrel) and etanercept (Remicade). (See drug interactions.)

Anakinra also is for used for treatment of neonatal-onset multisystem inflammatory disease (NOMID) due to cryopyrin-associated periodic syndromes (CAPS).

The most common side effects are reactions at the site of injection, for example, redness, swelling and pain.

Other minor side effects include:

• headache,
• flu-like symptoms,
• diarrhea and
• nausea.

The most serious side effects are an increase in infections and a decrease in the number of white blood cells (neutropenia) and platelets.

Anakinra should not be started in individuals with active infections.

Infections occur more frequently when anakinra is used in combination with drugs that block tumor necrosis factor.

• The dose of anakinra for rheumatoid arthritis is one subcutaneous injection of 100 mg daily. The dose should be administered at approximately the same time every day.
• The dose for treating neonatal-onset multisystem inflammatory disease (NOMID) is 1-2 mg/kg daily up to a maximum dose of 8 mg/kg.

Anakinra should not be combined with drugs that block tumor necrosis factor (TNF) alpha. Combining anakinra with drugs that block tumor necrosis factor such as infliximab (Enbrel) and etanercept (Remicade) or other drugs that reduce function of the immune system increases the risk of serious infections.

Anakinra has not been studied in pregnant women.

It is not known if anakinra is excreted in the breast milk of females who are nursing.

What preparations of anakinra are available?

Pre-filled syringes, 100 mg

How should I keep anakinra stored?

Anakinra should be kept refrigerated at 2 C to 8 C (36 F to 46 F)

How does anakinra work?

Anakinra blocks the effects of human interleukin-1, and is used in the treatment of rheumatoid arthritis. IL-1 is a protein that is produced by many cells in the body. It is found in increased amounts within joints that are inflamed by arthritis. IL-1 attaches to receptors on the tissues within and surrounding the joints as well as on the cells that are responsible for inflammation, for example, white blood cells. The attachment of IL-1 activates the cells to release enzymes that promote inflammation. The enzymes destroy the cartilage and bone and contribute to pain and swelling of the joints. Anakinra attaches to the IL-1 receptor and prevents IL-1 from attaching to the receptor. Thus, the inflammatory and enzyme-releasing effects of IL-1 are prevented and pain and swelling of the joints are reduced.

When was anakinra approved by the FDA?

Anakinra was approved by the Food and Drug Administration in November 2001.