Anakinra

Anakinra is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA). Anakinra is also used in Cryopyrin-Associated Periodic Syndromes. 

Anakinra is not widely used to treat RA but may be helpful in people who have not benefited from other treatments. Anakinra may be used as monotherapy or in combination with DMARD therapy, such as methotrexate (MTX).

Anakinra is delivered by subcutaneous (s.c.) injection — meaning in the fatty layer of tissue just under the skin — once daily.

The dose of anakinra is 100 mg daily. The medication comes in single-use pre-filled syringes for administration.

In some people with arthritis, a signalling protein called interleukin-1 (IL-1) is involved in the body’s inflammatory response where it attacks the body’s own tissues. Anakinra works by suppressing the body’s immune system, specifically it blocks IL-1 and prevents it from causing inflammation. By doing this, anakinra can help to reduce pain and swelling in the joints, improve day-to-day function, and prevent long term damage to the joints. 

IL-1 is also thought to be involved in the body’s process of breaking down bone and cartilage. Anakinra may help to prevent damage to cartilage and bones by blocking IL-1.  

As with all biologics, you may not feel the effects of the anakinra right away. Some people begin to feel the effects of the medication fairly quickly; however, it may take three to six months to feel its full effect. It is important to be patient and keep taking your medication.

To provide symptom relief while you are waiting for anakinra to take effect, your healthcare provider may recommend taking a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID).

Taking anakinra can make it more difficult for your body to fight infection. Therefore, people with active infections should not take anakinra. If you have a fever, think you have an infection or have been prescribed an antibiotic, contact your healthcare provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of anakinra with their healthcare provider.

Also contact your healthcare provider if you are having surgery as you may need to stop anakinra until you are healed and there is no sign of infection.

Anakinra has not been studied in pregnant people or lactating parents so its effect(s) on pregnant people or nursing babies are unknown. Anakinra should not be administered to pregnant people unless the benefits outweigh the potential risks. You should tell your doctor if you are pregnant or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your healthcare provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the lactating parent.

Anyone who has had a previous allergic reaction to anakinra should avoid the medication.

People with a history of cancer or emphysema should discuss the use of anakinra with their healthcare provider.

Make sure that your vaccinations are up to date before starting anakinra. Your healthcare provider will likely recommend a number of vaccines (e.g., influenzae, pneumonia, RSV, shingles) to get beforehand. Because anakinra can reduce your ability to react to vaccines, you should wait at least two to three weeks after your vaccine before starting anakinra. If you are already on anakinra and need a vaccination, try to space it as long as you can after your last dose.  Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking anakinra, you should speak with your healthcare provider.

Like all medications, taking anakinra carries some risk of side effects, which must be balanced with the potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from anakinra. When monitored properly the vast majority of side effects are rare, most improve over time and are reversible.

Anakinra can increase your risk of infections. You should take precautions to minimize your risk of being infected by common contagious infections such as COVID-19, influenzae, pneumonia, and the common cold.

In rare cases, people may experience headaches, nausea and abdominal pain while taking anakinra. If these symptoms become severe, please speak with your healthcare provider.

Anakinra can cause a reaction (redness, pain and itching) at the injection site. Talk to your healthcare provider if these symptoms become severe.

Also in rare circumstances, anakinra can affect your blood counts. Your prescriber will monitor for this.

Take anakinra as prescribed and contact your healthcare provider if you have any concerns while taking the medication.

To avoid injection reactions, rotate injection sites and avoid areas where the skin is tender, bruised, red and/or hard. Injection site reactions should resolve with time (uncommon after 1 month of therapy).

It is important to occasionally have your blood tested while taking anakinra. Your healthcare provider will order periodic blood tests to check your blood count and follow the activity of your arthritis.

Anakinra must be refrigerated at 2 to 8 degrees Celsius until you are ready to use it. Keep the product in the original package and out of the light.

Anakinra must be kept cool while travelling. Ask your pharmacist for a cool carrier if you are not able to put the drug in your refrigerator right away.

The patient support program for anakinra is called the “Kineret ON TRACK Patient Support Program”. Their phone number is 1-866-547-0644.