II. Indications

  1. Severe active Rheumatoid Arthritis refractory to DMARDs

III. Contraindications

  1. Chronic or acute infection
  2. Concurrent use of TNF antagonists (infection risk)
    1. Adalimumab (Humira)
    2. Etanercept (Enbrel)
    3. Infliximab (Remicade)

IV. Mechanism

  1. Interleukin-1 Receptor Antagonist

V. Dosing

  1. Adults: 100 mg SC qd with rotating injection sites

VI. Cost

  1. Vial of 100 mg/0.67 ml (7 doses): $260

VII. Adverse Effects

  1. Immunosuppression
    1. Use caution in any patient prone to infection
  2. Headache
  3. Injection site inflammation
  4. Gastrointestinal upset
  5. Leukopenia (including Neutropenia)

VIII. Monitoring

  1. Serum Creatinine
  2. Complete Blood Count with Neutrophil Count
    1. Baseline, then
    2. Monthly for 3 months, then
    3. Quarterly

IX. References

  1. (2003) Lexicomp Drug Database

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Cost: Medications

kineret (on 1/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
KINERET 100 MG/0.67 ML SYRINGE $192.31 per ml

Ontology: anakinra (C0245109)

Definition (NCI) A recombinant human nonglycosylated interleukin-1 (IL-1) receptor antagonist with potential antineoplastic activity. Anakinra binds to the IL-1 receptor, thereby blocking the binding of the IL-1 to and activation of its receptor. Blockade of IL-1 activity may inhibit the cascade of downstream pro-angiogenic factors such as vascular endothelial cell growth factor, tumor necrosis factor-alpha, and IL-6, resulting in inhibition of tumor angiogenesis. (NCI04)
Definition (NCI_NCI-GLOSS) A substance that is used to treat rheumatoid arthritis, and is being studied in the treatment of cancer. Anakinra blocks the action of interleukin 1 (IL-1). It is a type of interleukin receptor antagonist.
Definition (MSH) A synthetic form of native human IL-1Ra that has an additional methionine residue at its amino terminus.
Definition (PDQ) A recombinant human nonglycosylated interleukin-1 (IL-1) receptor antagonist with potential antineoplastic activity. Anakinra binds to the IL-1 receptor, thereby blocking the binding of the IL-1 to and activation of its receptor. Blockade of IL-1 activity may inhibit the cascade of downstream pro-angiogenic factors such as vascular endothelial cell growth factor, tumor necrosis factor-alpha, and IL-6, resulting in inhibition of tumor angiogenesis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43007&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43007&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C38717" NCI Thesaurus)
Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D053590
SnomedCT 395279009, 385549000
English Anakinra, anakinra (medication), Anakinra (obsolete), Anakinra [Chemical/Ingredient], rIL-1ra, rIL1RN, Kinaret, anakinra, Anakinra (product), Anakinra (substance), ANAKINRA
French Anakinra
German Anakinra
Czech anakinra
Japanese アナキンラ
Spanish anakinra (producto), anakinra (sustancia), anakinra

Ontology: Kineret (C1170364)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D053590
English Kineret, Amgen Brand of Anakinra, Anakinra Amgen Brand, kineret
French Kineret
German Kineret
Czech Kineret