Anakinra (Kineret)


Anakinra is a biologic drug that helps to decrease inflammation. Biologics are medicines that human made through genetic engineering techniques and closely related to 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

It is usually once a day injection under the skin. For rheumatoid arthritis, the standard dose is a 100 mg injection under the skin once a day. For children with NOMID and other autoinflammatory diseases, the dose is adjusted based on patient weight. The dose can be taken every other day in patients with decreased kidney function. Anakinra is effective by itself. In the case of rheumatoid arthritis, anakinra can be taken with other medications like methotrexate.

Anakinra must be stored in a refrigerator and warmed to room temperature before use. A nurse or physician can teach patients how to do the injections. It often helps to bring a family member 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 rheumatoid arthritis 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 February 2024 by Howard Yang, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information 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.

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