Side Effects of anakinra: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Main Research Findings

Anakinra is a recombinant interleukin-1 (IL-1) receptor antagonist used to treat systemic juvenile idiopathic arthritis (sJIA), refractory Kawasaki disease (KD), and cryopyrin-associated autoinflammatory syndrome (CAPS). Anakinra-associated hepatotoxicity, while rare, has been described in several cases in daily practice. 3 describes three pediatric patients who experienced this side effect in the context of severe macrophage activation syndrome (MAS) in KD and sJIA.

When delivered to the lungs, anakinra showed improved and extended therapeutic efficacy in CF models in vivo, along with higher potency compared to systemic delivery. 4

Anakinra impacted the quality of life of children with colchicine-resistant familial Mediterranean fever (FMF). 26

Anakinra led to improvements in metabolic and inflammatory parameters in participants with both rheumatoid arthritis (RA) and type 2 diabetes (T2D). 18

Reasons for side effects

Side effects of anakinra can occur due to the inhibition of the IL-1 pathway, leading to a suppression of the inflammatory response. IL-1 is a crucial cytokine responsible for triggering inflammatory reactions. Its inhibition can potentially increase the risk of infections or other complications.

Common side effects

Injection Site Reactions

According to 11 , injection site reactions are the most common side effect reported with anakinra administration.

Infections

Anakinra, due to its immunosuppressive effects, can potentially increase the risk of infections. 25 , 1

Hepatotoxicity

Anakinra may rarely cause hepatotoxicity. 3

Neurotoxicity

Anakinra can rarely lead to neurotoxicity. 13

Cytopenia

Anakinra may rarely cause cytopenia. 15

Side effect management

Injection Site Reactions

To minimize injection site reactions, it's recommended to store anakinra in the refrigerator before administration and to apply a cold compress after injection.

Infections

Regular infection screening during anakinra therapy is essential to minimize the risk of infections. If an infection occurs, appropriate treatment is required.

Hepatotoxicity

Regular liver function tests are important during anakinra therapy to minimize the risk of hepatotoxicity. If liver function abnormalities are detected, anakinra administration should be stopped.

Neurotoxicity

Close observation for neurological symptoms during anakinra therapy is important to minimize the risk of neurotoxicity. If any neurotoxic symptoms appear, anakinra administration should be discontinued.

Cytopenia

Regular blood tests are crucial during anakinra therapy to minimize the risk of cytopenia. If cytopenia is observed, anakinra administration should be stopped.

Comparison across studies

Similarities across studies

Several studies have demonstrated the efficacy of anakinra in treating various autoinflammatory diseases. These studies generally suggest that anakinra's side effects are typically mild and often manageable.

Differences across studies

Variations in patient populations, anakinra dosages, and study designs can lead to differences in research findings. For example, 6 suggests that in patients with familial Mediterranean fever (FMF), anakinra dosage may be adjusted or discontinued.

Cautions for real-life application

While anakinra is an effective drug for treating autoinflammatory diseases, it is essential to be aware of the potential for side effects. It's crucial to consult with a doctor before starting anakinra treatment and to fully understand the associated risks and benefits.

Limitations of current research

Many studies on anakinra are relatively small, and further research is necessary. Additionally, data on the long-term safety and efficacy of anakinra when administered for extended periods are lacking.

Future research directions

Further research on anakinra is needed to evaluate its long-term safety and efficacy, determine optimal dosages and administration methods, and elucidate its mechanism of action in greater detail.

Conclusion

Anakinra is a valuable drug for treating autoinflammatory diseases, but the potential for side effects should not be overlooked. Before starting anakinra therapy, consulting a doctor and fully understanding the risks and benefits is vital. We anticipate that future research will provide more information about anakinra's safety and efficacy.

Literature analysis of 27 papers
Positive Content
24
Neutral Content
1
Negative Content
2
Article Type
1
0
1
8
26
2.

Immune Effector Cell-Associated HLH-like Syndrome: A Review of the Literature of an Increasingly Recognized Entity.

Author: FugereTyler, BaltzAlan, MukherjeeAkash, GaddamMamatha, VarmaAnkur, VeeraputhiranMuthu, Gentille SanchezCesar Giancarlo

Cytokine release syndrome
Fatal toxicity

This review explores the prevalence, diagnostic criteria, and treatment recommendations for immune effector cell-associated HLH-like syndrome (IEC-HS), a potentially fatal toxicity associated with CAR-T cell therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Anakinra and hepatotoxicity in pediatric rheumatology: a case series.

Author: MartinsFrederico Rajão, AzevedoAndré Costa, GanhãoSara, AguiarFrancisca, RodriguesMariana, BritoIva

None mentioned
Hepatotoxicity

The study described three pediatric patients with anakinra-associated hepatotoxicity in the setting of severe macrophage activation syndrome (MAS) in Kawasaki disease (KD) and systemic juvenile idiopathic arthritis (sJIA).

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Pulmonary drug delivery technology enables anakinra repurposing in cystic fibrosis.

Author: PuccettiMatteo, ParianoMarilena, StincardiniClaudia, WojtyloPaulina, SchoubbenAurelie, NunziEmilia, RicciMaurizio, RomaniLuigina, GiovagnoliStefano

Anakinra efficacy
CF treatment
Side effects
Systemic toxicity

This study proposes a novel treatment for cystic fibrosis (CF) based on pulmonary administration of anakinra, a recombinant form of IL-1Ra. Inhaled anakinra demonstrated improved therapeutic efficacy and reduced systemic toxicity compared to systemic administration, offering a promising new approach to CF treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Anakinra for the Treatment of Hemophagocytic Lymphohistiocytosis: 21 Cases.

Author: BaverezClara, GrallMaximilien, Gerfaud-ValentinMathieu, De GailSarah, BelotAlexandre, PerpointThomas, WeberEmmanuelle, ReynaudQuitterie, SèvePascal, JamillouxYvan

Fever resolution
sHLH treatment
Side effects

This retrospective study evaluated the efficacy and safety of anakinra for the treatment of secondary hemophagocytic lymphohistiocytosis (sHLH). Anakinra was effective in 90.5% of patients, with fever resolution within a median of 1 day, and was well tolerated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Standard and increased canakinumab dosing to quiet macrophage activation syndrome in children with systemic juvenile idiopathic arthritis.

Author: KostikMikhail M, IsupovaEugenia A, BelozerovKonstantin, LikhachevaTatyana S, SuspitsinEvgeny N, RaupovRinat, MasalovaVera V, ChikovaIrina A, DubkoMargarita F, KalashnikovaOlga V, ChasnykVyacheslav G, CronRandy Q

MAS treatment
MAS
sJIA

Macrophage activation syndrome (MAS) is a life-threatening condition that can occur in people with systemic juvenile idiopathic arthritis (sJIA). IL-1 is a protein that plays a role in MAS. Anakinra is a drug that blocks IL-1 and can be used to treat MAS. In some cases, higher doses of anakinra may be needed to treat MAS that is resistant to standard doses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Current treatment options for monogenic periodic fever syndromes - the role of interleukin 1 inhibitors.

Author: MilotaTomáš, MalcováHana, StřížováZuzana, CebecauerováDita, HorváthRudolf

Autoinflammatory disease treatment

This review provides an updated perspective on the efficacy and safety of interleukin-1 (IL-1) inhibitors for the treatment of monogenic periodic fever syndromes, including new findings from recent clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Hyperinflammation after anti-SARS-CoV-2 mRNA/DNA vaccines successfully treated with anakinra: Case series and literature review.

Author: BindoliSara, GiolloAlessandro, GalozziPaola, DoriaAndrea, SfrisoPaolo

COVID-19 vaccine
Hyperinflammatory syndrome

This case series reports four patients who developed hyperinflammatory syndrome, with features of Adult-onset Still's disease (AOSD) and macrophage activation syndrome (MAS), after receiving the anti-SARS-CoV-2 vaccine. IL-1 inhibition with anakinra successfully reduced the cytokine release associated with the hyperinflammatory syndrome.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Emerging Therapies for Recurrent Pericarditis: Interleukin-1 inhibitors.

Author: Lo PrestiSaberio, ElajamiTarec K, ReyaldeenReza, AnthonyChris, ImazioMassimo, KleinAllan L

Pericarditis treatment

Interleukin-1 (IL-1) inhibitors have emerged as a promising treatment option for patients with recurrent pericarditis (RP), particularly those who are resistant to colchicine and dependent on steroids. This review examines the role of the IL-1 pathway in RP and discusses the efficacy and safety of IL-1 inhibitors in its treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Anti-interleukin-1 agents for pericarditis: a primer for cardiologists.

Author: ImazioMassimo, LazarosGeorge, GattornoMarco, LeWinterMartin, AbbateAntonio, BrucatoAntonio, KleinAllan

Reduces inflammation
Safe and effective
Treats pericarditis
Injection site reactions

Anti-interleukin (IL)-1 agents, including anakinra, rilonacept, and canakinumab, have emerged as effective treatments for recurrent idiopathic pericarditis. This article provides a comprehensive review of these agents, highlighting their efficacy and safety in treating corticosteroid-dependent and colchicine-resistant recurrent pericarditis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Long-term safety and efficacy of anakinra and canakinumab in patients with familial Mediterranean fever: a single-centre real-life study with 101 patients.

Author: AtasNuh, ErogluGulsah Atbiner, SodanHulya Nur, OzturkBeyza Olcay, BabaogluHakan, SatisHasan, KaradenizHazan, GulerAslihan Avanoglu, SalmanReyhan Bilici, GokerBerna, OzturkMehmet Akif, HaznedarogluSeminur, TufanAbdurrahman

Anakinra for FMF
Canakinumab for FMF
Anakinra side effects
Injection site reactions

Anakinra and canakinumab effectively manage familial Mediterranean fever long-term. Canakinumab has a favorable safety profile, while Anakinra has potential serious side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Exploring the role of polyphenols in rheumatoid arthritis.

Author: BehlTapan, MehtaKeshav, SehgalAayush, SinghSukhbir, SharmaNeelam, AhmadiAmirhossein, AroraSandeep, BungauSimona

Therapeutic efficacy in RA
Severe adverse effects

This review discusses the potential of dietary polyphenols for treating rheumatoid arthritis (RA). Polyphenols have shown anti-inflammatory, antioxidant, and immunosuppressive properties, which may be beneficial in managing RA. However, more clinical studies are needed to confirm their efficacy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

An open label trial of anakinra to prevent respiratory failure in COVID-19.

Author: KyriazopoulouEvdoxia, PanagopoulosPeriklis, MetallidisSymeon, DalekosGeorge N, PoulakouGaryphallia, GatselisNikolaos, KarakikeEleni, SaridakiMaria, LoliGeorgia, StefosAggelos, PrasianakiDanai, GeorgiadouSarah, TsachouridouOlga, PetrakisVasileios, TsiakosKonstantinos, KosmidouMaria, LygouraVassiliki, DareiotiMaria, MilionisHaralampos, PapanikolaouIlias C, AkinosoglouKarolina, MyrodiaDimitra-Melia, GravvaniAreti, StamouAliki, GkavogianniTheologia, KatriniKonstantina, MarantosTheodoros, TrontzasIoannis P, SyrigosKonstantinos, ChatzisLoukas, ChatzisStamatios, VechlidisNikolaos, AvgoustouChristina, ChalvatzisStamatios, KyprianouMiltiades, van der MeerJos Wm, Eugen-OlsenJesper, NeteaMihai G, Giamarellos-BourboulisEvangelos J

Anakinra efficacy
SRF prevention

Early suPAR-guided anakinra treatment reduced severe respiratory failure (SRF) and restored the pro-/anti-inflammatory balance in patients with COVID-19. The treatment was associated with a decrease in inflammatory mediators and a lower risk of 30-day mortality.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Benefits of anakinra versus TNF inhibitors in rheumatoid arthritis and type 2 diabetes: long-term findings from participants furtherly followed-up in the TRACK study, a multicentre, open-label, randomised, controlled trial.

Author: RuscittiPiero, BerardicurtiOnorina, CiprianiPaola, GiacomelliRoberto,

RA treatment
T2D treatment

This study assessed the long-term benefits of IL-1 inhibition with anakinra in patients with both rheumatoid arthritis (RA) and type 2 diabetes (T2D).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

IL-1 Inhibitors in the Treatment of Monogenic Periodic Fever Syndromes: From the Past to the Future Perspectives.

Author: MalcovaHana, StrizovaZuzana, MilotaTomas, StrizIlja, SedivaAnna, CebecauerovaDita, HorvathRudolf

Autoinflammatory disease treatment
IL-1 inhibition
Side effects

This review provides an overview of the use of IL-1 inhibitors in monogenic periodic fever syndromes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review.

Author: Plasencia-GarcíaBeatriz Oda, Rodríguez-MenéndezGonzalo, Rico-RangelMaría Isabel, Rubio-GarcíaAna, Torelló-IserteJaime, Crespo-FacorroBenedicto

Agitation management
Anxiety management
Delirium management
Drug-drug interactions

This systematic review aims to identify potential drug-drug interactions between COVID-19 treatments and antipsychotics, considering the importance of managing anxiety, delirium, and agitation in patients with COVID-19.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Anakinra treatment in patients with familial Mediterranean fever: a single-centre experience.

Author: UgurluSerdal, ErgezenBilgesu, EgeliBugra Han, SelviOguzhan, OzdoganHuri

FMF treatment

This study reviewed patients with Familial Mediterranean Fever (FMF) who received anakinra due to insufficient colchicine response. The results suggest that anakinra can be an effective treatment option for colchicine-resistant FMF patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Anakinra for Treatment-Resistant Kawasaki Disease: Evidence from a Literature Review.

Author: FerraraGiovanna, GianiTeresa, CaparelloMaria Costanza, FarellaCarla, GamaleroLisa, CimazRolando

KD treatment
Cardiac complications

This review summarizes the scientific literature on the use of anakinra, an interleukin-1 (IL-1) inhibitor, in the treatment of Kawasaki disease (KD), especially resistant cases. Data suggests that anakinra may be a valuable option after the failure of standard IVIG treatment, particularly in patients with coronary involvement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Anakinra for severe forms of COVID-19: a cohort study.

Author: HuetThomas, BeaussierHélène, VoisinOlivier, JouveshommeStéphane, DauriatGaëlle, LazarethIsabelle, SaccoEmmanuelle, NaccacheJean-Marc, BézieYvonnick, LaplancheSophie, Le BerreAlice, Le PavecJérôme, SalmeronSergio, EmmerichJoseph, MouradJean-Jacques, ChatellierGilles, HayemGilles

Neutralize hyperinflammatory state

This study aimed to assess the off-label use of anakinra, an IL-1 receptor antagonist, in patients with severe COVID-19 and symptoms of worsening respiratory function.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Early IL-1 receptor blockade in severe inflammatory respiratory failure complicating COVID-19.

Author: CauchoisRaphaël, KoubiMarie, DelarbreDavid, ManetCécile, CarvelliJulien, BlascoValery Benjamin, JeanRodolphe, FoucheLouis, BornetCharleric, PaulyVanessa, MazodierKarin, PestreVincent, JarrotPierre-André, DinarelloCharles A, KaplanskiGilles

Improved clinical outcomes

This retrospective study investigated the efficacy of early IL-1 receptor blockade with anakinra in COVID-19 patients with severe respiratory failure and systemic inflammation. The study found that anakinra treatment was associated with significant clinical improvement, including reduced oxygen requirements and fewer days on mechanical ventilation. These results suggest that early IL-1 blockade may be a promising therapeutic strategy for severe COVID-19 cases with hyperinflammation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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