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Kineret
Kineret (anakinra) is an immunomodulatory medication used to treat rheumatoid arthritis (RA) and other inflammatory conditions, such as Cryopyrin-Associated Periodic Syndromes (CAPS) and Still’s disease. Kineret works by inhibiting interleukin-1 (IL-1), a protein that plays a central role in the inflammatory process. By blocking IL-1 activity, Kineret helps reduce inflammation, pain, and joint damage in patients with rheumatoid arthritis and other autoimmune conditions.
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Frequently Asked Questions
How long does it take for Kineret to start working?
Patients may start to see improvements in their symptoms within 2 to 4 weeks of starting Kineret, though the full effects may take several months.
Can I take Kineret with other medications?
Kineret can be used with DMARDs such as methotrexate, but combining it with TNF inhibitors or other biologics may increase the risk of infections. Always consult your healthcare provider before combining treatments.
What should I do if I miss a dose of Kineret?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.
Can Kineret be used during pregnancy?
Kineret should be used during pregnancy only if clearly needed, as there is limited data on its safety in pregnant women. Discuss the risks and benefits with your healthcare provider.
How do I store Kineret?
Kineret should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F). Allow the syringe to reach room temperature before injecting, but do not leave it out for longer than 12 hours.
Comprehensive Drug Guide
How Does Kineret Work?
Kineret works by blocking the activity of interleukin-1 (IL-1), a cytokine that promotes inflammation. In conditions such as rheumatoid arthritis and CAPS, IL-1 is overproduced, leading to excessive inflammation, joint destruction, and pain. By inhibiting IL-1, Kineret helps reduce inflammation, slow down disease progression, and relieve symptoms associated with autoimmune diseases.
Common Dosages
- The typical dosage for adults with rheumatoid arthritis is 100 mg once daily.
- The dosage for CAPS may be adjusted based on the severity of the condition and body weight.
Typical Dosing
- For rheumatoid arthritis (RA): The typical dose is 100 mg once daily via subcutaneous injection.
- For CAPS and DIRA: The dosage is individualized based on the patient's body weight and response to treatment. Some patients may require higher or lower doses.
Typical Dosing
FDA Approved Indications
- Rheumatoid arthritis (RA) in adults who have failed one or more disease-modifying antirheumatic drugs (DMARDs)
- Cryopyrin-Associated Periodic Syndromes (CAPS), including Neonatal-Onset Multisystem Inflammatory Disease (NOMID)
- Deficiency of Interleukin-1 Receptor Antagonist (DIRA), a rare autoinflammatory disease
Who Shouldn't Take Kineret?
- Known hypersensitivity to anakinra or any component of the formulation
- Active serious infections, such as sepsis
- Severe kidney impairment, unless closely monitored, as dose adjustment may be required
Advice From The Pharmacist
- Kineret is administered via subcutaneous injection, usually in the abdomen, thigh, or upper arm. Patients can self-administer the injections after proper training, or they can receive the injections from a healthcare provider.
- Rotate injection sites to reduce the risk of skin irritation and injection site reactions.
- Before starting Kineret, ensure that you are screened for infections, as Kineret can lower the body's ability to fight infections.
- Store Kineret in the refrigerator and allow it to reach room temperature before injecting. Do not shake the pre-filled syringe.
- Do not use Kineret if it looks cloudy, discolored, or contains particles.
Side Effects of Kineret
Common Side Effects
- Injection site reactions (redness, swelling, or pain at the site)
- Headache
- Nausea
- Diarrhea
- Upper respiratory infections (e.g., common cold)
Uncommon/Severe Side Effects
- Serious infections, such as pneumonia or sepsis
- Neutropenia (low white blood cell count), which can increase the risk of infections
- Allergic reactions, including rash, swelling, or difficulty breathing
Risks and Warnings of Kineret
- Infection Risk: Kineret suppresses the immune system, increasing the risk of serious infections. Patients should be monitored for signs of infection during treatment, and treatment should be paused if a serious infection occurs.
- Neutropenia: Kineret may cause a decrease in neutrophils (a type of white blood cell), leading to an increased risk of infections. Regular blood tests are required to monitor white blood cell levels.
- Kidney Function: Patients with impaired kidney function may require dose adjustments and close monitoring, as Kineret is eliminated through the kidneys.
- Live Vaccines: Live vaccines should be avoided during treatment with Kineret, as the immunosuppressive effects of the drug can make the body less effective at fighting infections from live vaccines.
Interactions with Kineret
Common Drug Interactions
- TNF inhibitors (e.g., adalimumab, etanercept): Using Kineret with other immunosuppressive biologics can increase the risk of serious infections.
- Live vaccines: Avoid receiving live vaccines while taking Kineret, as the immune response may be diminished.
- Corticosteroids: While these may be used concurrently, they may increase the risk of infections when combined with Kineret.
Alternatives to Kineret
- Humira (adalimumab): A biologic TNF inhibitor used to treat rheumatoid arthritis and other inflammatory conditions.
- Enbrel (etanercept): A TNF inhibitor used to manage rheumatoid arthritis, psoriatic arthritis, and other autoimmune conditions.
- Actemra (tocilizumab): An IL-6 receptor antagonist used for rheumatoid arthritis and other inflammatory conditions.
- Methotrexate: A disease-modifying antirheumatic drug (DMARD) commonly used to manage rheumatoid arthritis and other autoimmune diseases.
