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Arcalyst
Arcalyst (rilonacept) is a biologic medication used to treat certain rare autoinflammatory conditions, including cryopyrin-associated periodic syndromes (CAPS) and deficiency of the interleukin-1 receptor antagonist (DIRA). It is an interleukin-1 (IL-1) inhibitor, which works by blocking the activity of IL-1, a protein that plays a key role in inflammation. Arcalyst helps reduce symptoms such as fever, rash, joint pain, and fatigue associated with these conditions.
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Frequently Asked Questions
How long does it take for Arcalyst to start working?
Many patients begin to experience symptom relief within a few days to weeks after starting Arcalyst, but it may take longer for full effects to be seen.
Can I administer Arcalyst at home?
Yes, after proper training by a healthcare provider, patients or caregivers can administer Arcalyst at home via subcutaneous injection. Always follow the specific instructions provided by your healthcare provider.
What should I do if I miss a dose of Arcalyst?
If you miss a dose, contact your healthcare provider for instructions. In general, you should take the missed dose as soon as you remember, but avoid doubling up doses.
Can Arcalyst cause weight gain?
Weight gain is not a common side effect of Arcalyst, but elevated cholesterol and triglyceride levels can occur, which could potentially affect weight over time.
Is Arcalyst safe for long-term use?
Arcalyst is generally considered safe for long-term use in treating autoinflammatory conditions. Regular monitoring of lipid levels and infection risk is recommended to ensure continued safety.
Comprehensive Drug Guide
How Does Arcalyst Work?
Arcalyst works by binding to interleukin-1 beta (IL-1β) and interleukin-1 alpha (IL-1α), preventing them from attaching to IL-1 receptors on cells. By blocking these inflammatory proteins, Arcalyst reduces the abnormal inflammatory response seen in conditions like CAPS and DIRA, helping to control symptoms such as fever, joint pain, and rashes.
Common Dosages
- Injection: 220 mg vial for subcutaneous administration
Typical Dosing
- The initial dose is typically 320 mg administered as two 160 mg subcutaneous injections on the same day.
- Following the initial dose, the typical maintenance dose is 160 mg once weekly as a single subcutaneous injection.
Typical Dosing
FDA Approved Indications
- Treatment of cryopyrin-associated periodic syndromes (CAPS), including familial cold autoinflammatory syndrome (FCAS) and Muckle-Wells syndrome (MWS) in adults and children aged 12 years and older
- Deficiency of interleukin-1 receptor antagonist (DIRA)
Who Shouldn't Take Arcalyst?
- Known hypersensitivity to rilonacept or any components of the formulation
- Active infections (such as tuberculosis), as Arcalyst suppresses the immune system, potentially worsening infections
Advice From The Pharmacist
- Arcalyst should be administered as a subcutaneous injection, typically under the skin of the abdomen, thigh, or upper arm.
- Rotate injection sites to prevent irritation or skin reactions.
- You should be monitored regularly for signs of infections, as Arcalyst can suppress the immune system.
- If you experience symptoms of infection, such as fever, chills, or persistent sore throat, contact your healthcare provider immediately.
Side Effects of Arcalyst
Common Side Effects
- Injection site reactions (redness, swelling, or pain)
- Upper respiratory tract infections
- Headache
Uncommon/Severe Side Effects
- Serious infections (such as pneumonia or tuberculosis)
- Allergic reactions (such as swelling, rash, difficulty breathing)
- Elevated cholesterol levels
Risks and Warnings of Arcalyst
- Risk of serious infections: Arcalyst can increase the risk of serious infections, including tuberculosis. Patients should be screened for tuberculosis before starting treatment and monitored for signs of infection during therapy.
- Lipid abnormalities: Arcalyst may increase cholesterol and triglyceride levels, so regular monitoring of lipid levels is recommended.
- Vaccinations: Live vaccines should be avoided while taking Arcalyst, as the medication may weaken the immune response to the vaccine.
Interactions with Arcalyst
Common Drug Interactions
- Immunosuppressive drugs: Combining Arcalyst with other immunosuppressants, such as TNF inhibitors or biologics, can increase the risk of infections.
- Live vaccines: Live vaccines should be avoided during treatment with Arcalyst, as the immune suppression can increase the risk of vaccine-related infections.
Alternatives to Arcalyst
- Ilaris (canakinumab): Another IL-1 inhibitor used to treat CAPS and other inflammatory conditions.
- Kineret (anakinra): An IL-1 receptor antagonist used to treat rheumatoid arthritis and CAPS.
- Humira (adalimumab): A TNF inhibitor used for a variety of inflammatory conditions, including juvenile idiopathic arthritis and ankylosing spondylitis.
