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Anakinra
Anakinra is a recombinant interleukin-1 receptor antagonist (IL-1Ra). It is used to reduce inflammation in rheumatoid arthritis, Still’s disease, and rare autoinflammatory conditions. By blocking IL-1–mediated pathways, it slows disease progression, reduces joint damage, and alleviates systemic inflammation. Always check the BNF link here for the latest prescribing advice.
⚙️ Mechanism of Action
- Competitive antagonist at the IL-1 receptor, blocking IL-1α and IL-1β signalling.
- Inhibits downstream cytokine cascades → ↓ neutrophil recruitment, ↓ synovial inflammation.
- Clinically improves pain, swelling, and prevents radiographic progression of joint disease.
💊 Dose Range (Confirm with BNF or product SPC)
| Indication | Details |
|---|---|
| 🦴 Rheumatoid Arthritis |
Anakinra
• 100 mg SC injection OD |
| 🧒 Still’s Disease (incl. systemic JIA & AOSD) |
Anakinra
• Adults: 100 mg SC injection OD • Children: Weight-based dosing |
| 🔥 Other Autoinflammatory Syndromes (e.g. CAPS, FMF) |
Anakinra
• Variable specialist dosing • Usually OD, may ↑ to BD in severe disease |
⚠️ Cautions & Contraindications
- Active or recurrent infections (risk of sepsis).
- Neutropenia — check baseline and monitor regularly; avoid if neutrophils very low.
- Asthma — higher risk of hypersensitivity reactions.
- Renal impairment — mainly renally excreted; accumulation possible if eGFR < 30 mL/min.
- Avoid use with TNF-α inhibitors (markedly ↑ infection risk).
- Screen for latent TB and hepatitis before initiation.
🧪 Monitoring
- Baseline and regular FBC (esp. neutrophils, platelets).
- Renal function (adjust dose if severe impairment).
- Monitor for infection symptoms throughout therapy.
⚠️ Side Effects
- Very common: injection site reactions (pain, erythema, swelling).
- Headache, nausea, diarrhoea.
- Infections: URTIs, cellulitis, pneumonia.
- Haematological: neutropenia, thrombocytopenia.
- Rare: hypersensitivity, anaphylaxis, liver enzyme elevation.
📚 References
- BNF: Anakinra
- MHRA / EMA Summary of Product Characteristics (SPC)
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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