|Elimination half-life||4-6 hrs|
|Chemical and physical data|
|Molar mass||17,257.6 g/mol g·mol−1|
|(what is this?)|
Anakinra (brand name Kineret) is a biopharmaceutical drug used to treat rheumatoid arthritis. It is a recombinant and slightly modified version of the human interleukin 1 receptor antagonist protein. It is marketed by Swedish Orphan Biovitrum.
Anakinra is administered at home by subcutaneous injection.
It is used as a second line treatment to manage symptoms of rheumatoid arthritis after treatment with a disease-modifying antirheumatic drug (DMARD) has failed. It can be used in combination with some DMARDs.
It was not tested in pregnant women, but appeared to be safe in animal studies.
More than ten percent of people taking anakinra have injection site reactions, headaches, and have increased levels of cholesterol in their blood. Between one and ten percent of people have severe infections, decreased white blood cells, or decreased platelets. It is unclear if taking anakinra increases the risk of getting cancer; studies are complicated by the fact that people with rheumatoid arthritis are already at higher risk of getting cancer.
Anakinra is a protein that differs from the sequence of Interleukin 1 receptor antagonist by one methionine added to its N-terminus; it also differs from the human protein in that it is not glycosylated, as it is manufactured in Escherichia coli.
In June 2018 NHS England published a Clinical Commissioning Policy: Anakinra to treat periodic fevers and autoinflammatory disorders (all ages) allowing Anakinra to be commissioned as a first-line treatment for Schnitzler's syndrome and in cases where the first-line treatment is not effective for Familial Mediterranean fever, Hyper-IgD syndrome also known as Mevalonate kinase deficiency, and TNF receptor associated periodic syndrome (TRAPS), and a Clinical Commissioning Policy: Anakinra/tocilizumab for the treatment of Adult-Onset Still's Disease refractory to second-line therapy (adults), allowing Anakinra to be commissioned for Adult-onset Still's disease "as a third line treatment where patients are refractory to steroid-sparing effect DMARDs". Anakira effectively treated meningitis caused by a rare genetic mutation in the gene NALP3 in a 67-year-old man enrolled in the Undiagnosed Diseases Network.
- "UK Anakinra label". UK Electronic Medicines Compendium. 5 October 2017. Retrieved 23 March 2018.
- "US Anakinra label" (PDF). FDA. May 2016. Retrieved 23 March 2018. For label updates see FDA index page for BLA 103950
- Singh, JA; Hossain, A; Tanjong Ghogomu, E; Kotb, A; Christensen, R; Mudano, AS; Maxwell, LJ; Shah, NP; Tugwell, P; Wells, GA (13 May 2016). "Biologics or tofacitinib for rheumatoid arthritis in incomplete responders to methotrexate or other traditional disease-modifying anti-rheumatic drugs: a systematic review and network meta-analysis". The Cochrane Database of Systematic Reviews (5): CD012183. doi:10.1002/14651858.CD012183. PMID 27175934.
- Gusdorf, L; Lipsker, D (August 2017). "Schnitzler Syndrome: a Review". Current Rheumatology Reports. 19 (8): 46. doi:10.1007/s11926-017-0673-5. PMID 28718061.
- NHS England (29 June 2018). Clinical Commissioning Policy: Anakinra to treat periodic fevers and autoinflammatory disorders (all ages) (PDF). Retrieved 9 July 2018.
- NHS England (29 June 2018). Clinical Commissioning Policy: Anakinra/tocilizumab for the treatment of Adult-Onset Still's Disease refractory to second-line therapy (adults) (PDF). Retrieved 13 July 2018.
- Kolata, Gina (2019-01-07). "When the Illness Is a Mystery, Patients Turn to These Detectives". The New York Times. ISSN 0362-4331. Retrieved 2019-01-09.