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My doctor wants me to start Kineret for my rheumatoid arthritis - what is it?
Kineret – the chemical name is Anakinra – is a biological drug that blocks the effects of interleukin 1. Interleukin 1 is a protein that is produced in excess in people with rheumatoid arthritis (RA). It appears to be the most important protein involved in the inflammation of rheumatoid arthritis, along with tumor necrosis factor (TNF). Interleukin 1 is a major contributor to the pain, inflammation, and joint damage that occurs with RA. Kineret must be injected subcutaneously (under the skin) daily. The dose is 100 mg per day. It is recommended for patients who are on other therapies for rheumatoid arthritis such as methotrexate or...
My doctor wants me to start Kineret for my rheumatoid arthritis - what is it?
Kineret – the chemical name is Anakinra – is a biological drug that blocks the effects of interleukin 1. Interleukin 1 is a protein that is produced in excess in people with rheumatoid arthritis (RA). It appears to be the most important protein involved in the inflammation of rheumatoid arthritis, along with tumor necrosis factor (TNF).
Interleukin 1 is a major contributor to the pain, inflammation, and joint damage that occurs with RA. Kineret must be injected subcutaneously (under the skin) daily. The dose is 100 mg per day. It is recommended for patients who do not experience effective relief from other rheumatoid arthritis therapies such as methotrexate or anti-TNF medications such as Enbrel, Humira and Remicade.
The clinical trials that studied Kineret showed that the drug resulted in a 20 percent improvement in 34 to 43 percent of patients who took the drug compared to 22 to 27 percent of patients who received a placebo. These statistics are not that impressive.
Side effects of anakinra include bruising and pain at the injection sites and an increased risk of infection. Kineret should not be used with anti-TNF drugs because this combination significantly increased the infection rate in the one large clinical trial that evaluated the combination.
Anakinra should not be started in patients with an active infection. It should be performed in patients who develop a significant infection (one that requires antibiotic therapy). It can be started again once the infection is under control and the course of antibiotics is completed.
Another side effect is a drop in the number of white blood cells. Routine laboratory tests including a complete blood count and chemical panel should be performed monthly.
Our experience with Kineret is not positive. It appears to work in a minority of patients. There may be a niche for this drug somewhere. Nevertheless, it is worth a try in patients for whom other biological therapies have failed.
Inspired by Nathan Wei