Anakinra

Also Known As: Anakinra, Kineret

Anakinra, sold under the brand name Kineret, is a biopharmaceutical medication used to treat rheumatoid arthritis, cryopyrin-associated periodic syndromes, familial Mediterranean fever, and Still's disease.[3] It is a recombinant and slightly modified version of the human interleukin 1 receptor antagonist protein.[3] It is marketed by Swedish Orphan Biovitrum.[1] Anakinra is administered by subcutaneous injection.[2]

It is used as a second line treatment to manage symptoms of rheumatoid arthritis after treatment with a disease-modifying antirheumatic drug (DMARD) has failed.[1][2] It can be used in combination with some DMARDs.[1][2][4]

It is used to people with a cryopyrin-associated periodic syndrome, including neonatal-onset multisystem inflammatory disease.[1][2]

It is used to treat Schnitzler's syndrome (off label in the US).[5] Its response rate is such that it has been suggested that "Treatment failures should lead to reconsider the diagnosis."[6]

Off label, it is used to treat systemic juvenile idiopathic arthritis (SJIA), gout, calcium pyrophosphate deposition (CPPD), Behçet's disease, ankylosing spondylitis, uveitis, and other auto-inflammatory syndromes.[7]

In December 2021, the European Medicines Agency authorized the use of anakinra "to treat COVID-19 in adults with pneumonia requiring supplemental oxygen (low or high flow oxygen) and who are at risk of developing severe respiratory failure, as determined by blood levels of a protein called suPAR (soluble urokinase plasminogen activator receptor) of at least 6 ng per ml."[3][8][9] In November 2022, the United States FDA approved its use under an emergency use authorization "for the treatment of COVID-19 in hospitalized adults with pneumonia requiring supplemental oxygen (low- or high-flow oxygen) who are at risk of progressing to severe respiratory failure and likely to have an elevated plasma soluble urokinase plasminogen activator receptor (suPAR)."[10][11]

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