anakinra

Anakinra is a recombinant human interleukin-1 receptor antagonist (IL-1Ra) used as an anti-inflammatory biologic. By competing with interleukin-1 (IL-1) for binding to the IL-1 receptor type I, it blocks signaling from IL-1 alpha and IL-1 beta, reducing inflammatory responses.

Indications include rheumatoid arthritis in adults, typically in combination with methotrexate, and a group of autoinflammatory syndromes such as cryopyrin-associated periodic syndromes (CAPS) and neonatal-onset multisystem inflammatory disease (NOMID), also known as CINCA. It is also used in pediatric patients for certain inflammatory conditions, including systemic juvenile idiopathic arthritis, where appropriate.

Anakinra is administered by subcutaneous injection, usually once daily. Dose is individualized based on the condition, body weight, and response, with adjustments for renal impairment as needed.

Pharmacokinetically, anakinra has a relatively short half-life of about 4–6 hours and is cleared primarily by proteolytic enzymes with renal elimination. Common adverse effects include injection-site reactions, neutropenia, and an increased risk of infections. Serious infections and hypersensitivity reactions can occur; vaccination status should be updated prior to initiation, and live vaccines are generally avoided during treatment. Monitoring of blood counts and liver enzymes may be recommended in some patients.

Regulatory status and brand: anakinra is marketed under the brand name Kineret and is available in multiple countries. It is categorized as a biologic disease-modifying antirheumatic drug (bDMARD).