GENERIC NAME: anakinra

BRAND NAME: Kineret

DRUG CLASS AND MECHANISM: Anakinra is a synthetic (man-made), injectable, interleukin-1 receptor antagonist that blocks the effects of human interleukin-1. It is used in the treatment of rheumatoid arthritis . Interleukin-1 (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 . The 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 promote inflammation and release enzymes. 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. Anakinra was approved by the Food and Drug Administration in November, 2001.

PRESCRIPTION: yes

GENERIC AVAILABLE: No

PREPARATIONS: Pre-filled syringes, 100 mg

STORAGE: Anakinra should be refrigerated at 2-8°C (36-46°F)

PRESCRIBED FOR: 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 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 such as infliximab (Enbrel) and etanercept (Remicade). (See below.)

DOSING: The daily dose of anakinra in rheumatoid arthritis is one subcutaneous injection of 100 mg daily. The dose should be administered at approximately the same time every day.

DRUG INTERACTIONS: Studies of interactions between anakinra and other drugs have not been conducted.

PREGNANCY: Anakinra has not been studied in pregnant women.

NURSING MOTHERS: It is not known if anakinra is excreted in the breast milk of nursing mothers.

SIDE EFFECTS: 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.

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