Anakinra (Kineret)


What Is It?

Anakinra is a biologic drug that helps to decrease inflammation in rheumatoid arthritis (RA) and other inflammatory diseases. It is a biologic drug that is man-made through genetic-engineering techniques and closely mimics a protein that occurs naturally in the body.

Anakinra is FDA-approved to treat rheumatoid arthritis, deficiency of interleukin-1 antagonist, and neonatal-onset multisystem inflammatory disease (NOMID). Although not FDA-approved, anakinra is sometimes used for systemic juvenile idiopathic arthritis (SJIA), Adult-Onset Still’s Disease (AOSD), gout, and other autoinflammatory syndromes.

How to Take It

For RA, the standard dose is 100 mg per day injected under the skin. In children with NOMID and other autoinflammatory diseases, the dose is adjusted based on patient weight. In children, the starting dose is 1-2 mg/kg daily. The dose can be taken every other day in patients with decreased kidney function. Anakinra is effective by itself. In the case of RA, anakinra can be taken with methotrexate.

Anakinra must be stored in a refrigerator and warmed to room temperature before use. A nurse or physician can teach patients how to give themselves the injections. It often helps to bring a spouse or friend along to learn how to do the injections. Anakinra can be injected in the front of the thigh or abdomen. Injection sites should be rotated so that the same site is not used repeatedly.

Anakinra relieves symptoms of RA in 4 to 6 weeks. In NOMID, systemic juvenile idiopathic arthritis, Adult-Onset Still’s Disease, gout, and other autoinflammatory disorders, anakinra may begin to relieve symptoms within hours.

Side Effects

The most common side effects are reactions around the site of injection, such as redness, itching, rash and pain. Bruising or bleeding can also occur, but it is rare. These effects usually stop after 1-2 weeks. Headaches and low white blood cell counts can occur, but these are very rare.

Anakinra has no known interactions with other medications. Anakinra should not be used at the same time as other biologics, as they increase the risk for infection.

Tell Your Rheumatology Provider

Anakinra can increase your risk of infection. See your rheumatology provider if you are not feeling well or if you develop a fever. Your doctor can stop anakinra and start antibiotics, if needed. Anakinra blocks one of the pathways that cause inflammation—this pathway is also used to fight infections. Patients taking anakinra should not receive live vaccines, such as certain forms of the influenza vaccine, and yellow fever. Please consult your rheumatology provider beforehand.

Updated March 2023 by Howard Yang, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This patient fact sheet is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

We use cookies on our website to improve our service to you and for security purposes. By continuing to use our site without changing your browser cookie settings, you agree to our cookie policy and the use of cookies. See ACR Policies