Anakinra

Anakinra inhibits the activity of interleukin-1 (IL-1). It antagonizes IL-1 action at its receptor, blocking IL-1 activity in vitro and in vivo. This thereby inhibits the progression of structural damage associated with active rheumatoid arthritis and other inflammatory conditions.

Adult

Rheumatoid arthritis: 100 mg once daily by subcutaneous injection. Cryopyrin-associated periodic syndromes: 1–2 mg/kg daily by subcutaneous injection; for severe cases, usual maintenance is 3–4 mg/kg daily by subcutaneous injection. Still’s disease: For body-weight up to 49 kg, 1–2 mg/kg daily by subcutaneous injection; for body-weight 50 kg and above, 100 mg daily by subcutaneous injection.

Hepatic adjustment

Manufacturer advises caution in severe impairment.

Max dose

8 mg/kg daily (for severe cryopyrin-associated periodic syndromes)

• Active infection
• Neutropenia (absolute neutrophil count less than 1.5 x 10^9/litre)—do not initiate
• Pre-existing malignancy
• live vaccines