An interleukin-1 blocker injected under the skin
Anakinra
A daily under-the-skin injection that blocks an inflammatory signal to treat rheumatoid arthritis and some auto-inflammatory conditions.
What is Anakinra?
Anakinra is a specialist medicine used to treat rheumatoid arthritis and certain auto-inflammatory conditions, where the immune system causes harmful inflammation. It works by blocking a natural inflammatory signal called interleukin-1, which helps reduce joint inflammation or the flares of these conditions. It is given as an injection under the skin, usually once a day, which people often do themselves after training. Because it dampens part of the immune system it can make infections more likely, and the most common nuisance is a reaction where the injection is given.
Education and reference only. This is a plain-language guide to Anakinra — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Anakinra is a medicine used to treat rheumatoid arthritis, where the immune system attacks the joints, and a number of auto-inflammatory conditions in which the body produces excessive inflammation. It works by blocking the action of interleukin-1, a natural chemical messenger that drives inflammation. By getting in the way of this signal, it calms the inflammation that causes joint damage or the recurring flares seen in auto-inflammatory diseases. It is given as a daily injection under the skin, which people are usually trained to do themselves, and is prescribed and supervised by a specialist team.
How it works
Interleukin-1 is a natural messenger the body releases to drive inflammation. In rheumatoid arthritis and auto-inflammatory conditions, too much of this signal causes ongoing or recurring inflammation that damages tissues and causes symptoms such as joint pain, swelling, fevers and rashes. Anakinra blocks the receptor that interleukin-1 normally acts on, so the inflammatory message cannot get through. With this signal turned down, inflammation eases and symptoms improve. Because it works only while it is present in the body and is cleared fairly quickly, it is given every day to keep the inflammation under control.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist immune-modulating medicine used in the UK for rheumatoid arthritis and some auto-inflammatory conditions, given as a daily injection under the skin.
What it treats
Conditions Anakinra is used for
Practical use
How to take Anakinra
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Give the injection under the skin once a day, at about the same time, as your specialist team has trained you.
- Rotate the injection site and follow the technique you were shown to reduce skin reactions.
- Report any fever or signs of infection promptly, as treatment may need to be paused.
- Check before having any vaccinations, as some live vaccines should be avoided while on it.
- Keep up with blood-test appointments so your blood counts and response can be monitored.
Weighing it up
Advantages & disadvantages of Anakinra
Advantages
- Reduces inflammation in rheumatoid arthritis and a range of auto-inflammatory conditions.
- Leaves the body quickly, so its effect wears off soon after stopping if that is needed.
- Can be given as a self-injection at home after training.
Disadvantages
- Needs a daily injection, which some people find more demanding than less frequent treatments.
- Commonly causes reactions where the injection is given, especially early on.
- Lowers part of the immune response, so it can make infections more likely.
Practical use
Good to know
Anakinra is given as a daily injection under the skin, so getting comfortable with the injection technique, and rotating where you inject, helps make it part of a routine. The most common nuisance is a reaction where the injection is given, with redness, swelling, itching or discomfort, which is usually mild and tends to settle over the first few weeks. Because it dampens part of the immune system, it can make infections more likely, so any fever or signs of infection should be reported, and it is usually paused if you develop a serious infection. Vaccinations are best kept up to date, with some live vaccines avoided while on it, and the team checks blood counts during treatment. One advantage is that, because it leaves the body quickly, its effect wears off soon after stopping if that is ever needed.
Who should not take it / use with caution
- People who have had a serious allergic reaction to anakinra, or to medicines made using similar methods, should not use it.
- It is not started in people with a serious active infection, and is usually paused during one.
- It is used with caution in people with very low white blood cell counts and is used with care under specialist guidance in pregnancy.
Monitoring
- Watching for signs of infection, with treatment usually paused during a serious one.
- Checking blood counts, including white blood cells, during treatment.
- Reviewing how well the joint or inflammatory symptoms are responding over time.
Side effects
- Reactions where the injection is given, such as redness, swelling, itching or discomfort, especially at first.
- Infections, such as chest or other infections, because the immune response is lowered.
- Headache or a drop in certain blood cell counts in some people.
- Rarely but seriously, severe infections or serious allergic reactions, which need urgent attention.
Key interactions
- It is generally not combined with certain other immune-targeting biologic medicines because of the added infection risk.
- Some live vaccines should be avoided during treatment, so plan vaccinations with your team.
- Tell your team about all your medicines so any added risks can be considered.
Available as: A solution for injection under the skin, often given by the patient.
Answers
Anakinra: frequently asked questions
What is anakinra used for?
It is used to treat rheumatoid arthritis and some auto-inflammatory conditions by blocking a natural inflammatory signal called interleukin-1, which reduces inflammation.
How often is it given?
It is given as an injection under the skin once a day, which people are usually trained to do themselves at home.
Why does the injection site react?
Reactions where the injection is given, such as redness, swelling or itching, are the most common side effect, usually mild and tending to settle over the first few weeks.
Does it make infections more likely?
Yes. Because it dampens part of the immune system, it can make infections more likely, so report any fever or signs of infection, as treatment may need to be paused.
What happens if I stop it?
Anakinra leaves the body quickly, so its effect wears off soon after stopping; never change or stop treatment without your specialist team's advice.
Authoritative sources
- BNF
- NICE CKS
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