What is Anakinra?
Anakinra is a targeted disease modifying anti-rheumatic drug (DMARD) that is used to reduce inflammation produced by the body. In certain diseases the immune system is over active, this can target healthy tissues such as joints. Anakinra works on the inflammatory pathway to target a protein called IL-1, thereby reducing the symptoms you get from inflammation such as arthritis and reduces the chance of further damage to the joints and organs.
What is Anakinra used for?
Anakinra is used for the treatments of inflammatory diseases such as:
How is it taken?
Anakinra is given as an injection into the layer of fat between the skin and muscle. This is called a subcutaneous injection and is usually given into the thigh or abdomen. It can be given alone or in combination with other DMARDs such as methotrexate.
The injection device is available as a prefilled syringe. It should be stored in the fridge at home.
The dose is dependent on the underlying disease that is being treated. For rheumatoid arthritis the dose is a 100mg injection each day. For Adult onset Stills disease, the daily dose is based on your weight.
It can take up to 12 weeks to have an effect. You will be seen in clinic at around this point to see how you are getting along.
When you first start taking it you will need your bloods monitored. This is done every month for the first 6 months. If they are satisfactory, this is then dropped down to every 3 months. This can be combined with your blood monitoring if you are on other medications.
There are a few possible side effects that can occur in a small number of people that take anakinra, these include:
- These usually settle after taking the medication for a few weeks.
- Increased risk of infections
- As anakinra dampens the immune system, you can be more prone to infection. You should be seen by your GP if you feel unwell in case you need antibiotics. You must temporarily stop your injections whilst you are unwell and receiving treatment, they can be started up again when you feel well.
- You should try to avoid contact with others that have chicken pox or shingles.
- Injection site reactions
- Irritation, rashes and bruising can occur
- Mild steroid creams and antihistamines can be used to settle things down. If these don’t work, then you should see your GP.
Cautions of use
Interactions with other medications
- Your doctor will check if there are any medications that could interact.
- You can carry on taking your usual painkillers including NSAIDs.
Contraindications of other conditions
- Before starting any biological therapy, your bloods will be checked for infections that can become active again when the immune system is suppressed, this includes hepatitis B, C and HIV. A blood and chest X-ray is taken to exclude previous TB exposure. If you are found to have had previous TB exposure you may need to start preventative antibiotics for a short period before the anakinra is commenced.
- If you are being investigated for or diagnosed with cancer, anakinra must be stopped.
- If you are taking anakinra and require surgery, you should discuss this with your doctor or nurse specialist.
During pregnancy and breastfeeding
- There is currently no data on anakinra in pregnancy or breastfeeding. Therefore it should not be used.
- If you are considering starting a family, contraception should be continued during treatment and for at least 1 week after stopping.
- Alcohol and anakinra do not interact, however it is recommended to take alcohol within moderation, following the guidelines of less than 14 units weekly.
- Flu and the pneumonia vaccine are safe and recommended whilst taking anakinra.
- Live vaccines including the shingles vaccine should not be given due to the dampening down of the immune system.