Anakinra is a drug commonly used to treat inflammatory diseases such as rheumatoid arthritis. Before using Anakinra, patients need to be aware of some important precautions. Patients should tell their doctors about their allergies, especially allergic reactions to Anakinra or other similar drugs. In addition, they need to tell their doctors about other drugs they are currently taking, including prescription drugs, over-the-counter drugs, and supplements. Patients also need to tell their doctors about their medical history, such as immune system problems, history of infection, etc. This information will help doctors evaluate whether patients are suitable for Anakinra and determine the appropriate medication regimen.
Precautions for Anakinra
1. Serious infection
In clinical trials, the incidence of infection increased with the use of Anakinra for rheumatoid arthritis. If patients develop serious infections, Anakinra should be discontinued. For patients with multisystem inflammatory disease (NOMID)
and interleukin-1 receptor antagonist deficiency (DIRA) who are treated with Anakinra, the risk of disease recurrence when stopping Anakinra treatment should be weighed against the potential risks of continuing treatment.
Patients with active infection should not be treated with Anakinra. The safety and effectiveness of Anakinra in immunosuppressed patients or those with chronic infection have not been evaluated.
Drugs that affect the immune system by blocking tumor necrosis factor (TNF) are associated with an increased risk of reactivation of latent tuberculosis (TB). Taking drugs that block IL-1, such as Anakinra, may increase the risk of TB or other atypical or opportunistic infections. Before starting treatment with Anakinra, healthcare providers should follow current guidelines from the (CDC) to evaluate and treat possible latent TB infection.
2. Use with TNF blockers
The combination of Anakinra and TNF blockers is not recommended.
3. Allergic reactions
Allergic reactions, including anaphylaxis and angioedema, have been reported with the use of Anakinra. If a severe hypersensitivity reaction occurs, Anakinra should be discontinued and appropriate treatment initiated.
Anakinra is a recombinant form of IL-1Ra that is deficient in patients with interleukin-1 receptor antagonist deficiency (DIRA). Patients with DIRA may be at increased risk for allergic reactions, especially in the first few weeks after starting Anakinra therapy. Patients should be closely monitored during this period. If a serious allergic reaction occurs, appropriate treatment should be initiated promptly and discontinuation of Anakinra should be considered.
4. Immunosuppression
The effects of treatment with Anakinra on active and/or chronic infections and the development of malignancies are unknown.
5. Immunizations
There are currently no data on the efficacy of other inactivated antigen vaccines in patients receiving Anakinra. There are no data on the efficacy of live vaccines or the transmission of secondary infections with live vaccines in patients receiving Anakinra. Therefore, live vaccines should not be administered at the same time as Anakinra.
6. Neutrophil counts
Neutrophil counts may decrease in patients receiving Anakinra. Therefore, neutrophil counts should be assessed monthly before and during Anakinra therapy for 3 months and quarterly thereafter for up to 1 year.
