The last of our biologic medications used for rheumatoid arthritis is an interleukin-1 receptor antagonist called Anakinra. It is a targeted biologic depressing a specific protein in the body’s protective inflammatory process. Anakinra, brand name Kineret, was approved for rheumatoid arthritis use in 2001. It is manufactured by Swedish Orphan  Biovitrum AB.

In clinical studies, 38 to 43% patients reached an ACR20* at 6 months. 11 to 19%  reached an ACR50  at six months. 1 to 6% reached an ACR70 at six months. Although it isn’t as effective as some of the other RA biologics, Anakinra  becomes useful for people who do not tolerate other biologics.

Anakinra is taken daily. The dose is 100 mg injection under the skin. It is sold in single use syringes. It must be kept refrigerated until 30 minutes before use.  

Serious side effects may include

• serious infections such as pneumonia
• worsening RA symptoms
• allergic reactions ranging from anaphylactic shock to milder allergic reaction.

Common side effects

• The most common side effect is injection site reaction including redness,  inflammation and pain. This localized effect lasts up to 21 days and usually subsides.
• A person on Anakinra may have flu symptoms, headaches, and increased blood cholesterol.

Pregnancy and lactation

Pregnant women or women who were nursing were not included in the initial clinical studies of Anakinra. The safety of Anakinra for pregnant or nursing women is not known.

*Remember ACR is American College of Rheumatology. The ACR20, ACR50, ACR70 are specific scores used to determine the effectiveness of RA drugs.  ACR20 means that an RA drug has a 20% effectiveness, ACR50 has an 50% effectiveness, and ACR70 means a drug has a 70% effectiveness.