Kineret May Help Ease the Pain of Rheumatoid Arthritis
On January 23, 2002, the Food and Drug Administration (FDA) approved a drug to help ease the pain and swelling caused by rheumatoid arthritis (RA). Anakinra (Kineret) is indicated for adults with moderately to severely active RA who have not found relief from other treatments.
Kineret directly blocks the action of the protein interleukin-1 (IL-1). IL-1 is produced in excessive amounts in people with RA. High levels of IL-1 contribute to the joint pain, swelling, and stiffness of RA. By blocking IL-1, Kineret can help reduce these symptoms.
What the Research Shows
In clinical studies, 38% of patients who received Kineret for six months experienced less swelling and pain, compared with 22% who were given a placebo. Patients receiving anakinra also developed fever bony erosions, the hallmark of aggressive, deforming disease.
The FDA points out that the effects of Kineret are modest. In comparison, 66% of patients given etanercept (Enbrel) or infliximab (Remicade), two drugs presently available for RA patients, showed improvement in their conditions. These two drugs also work by inhibiting protein action, but they block a different protein—tumor necrosis factor (TNF).
Some positive effects occurred within four weeks of beginning Kineret therapy, while most were seen after 13 weeks.
Kineret is given once a day as an injection. The main side effect of this drug is mild redness, swelling, and pain at the injection site. In addition, because Kineret suppresses the immune system, it carries with it a small risk of serious infection. During research trials, 2% of patients taking Kineret and 1% of those given the placebo developed a serious infection, though none were fatal.
Not for Everyone
Kineret is not indicated for all people with RA. In the following cases, talk to your doctor about the safety of taking Kineret:
- If you have a fever, or suspect you have an infection
- Do not take Kineret if you are taking etanercept (Enbrel) or infliximab (Remicade); these drugs also increase the risk of infection.
- If you have asthma
- If you are allergic to proteins made from bacteria cells
RESOURCES:
US Food and Drug Administration
http://www.fda.gov
Arthritis Foundation
http://www.arthritis.org/
CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca/
Canadian Pharmacists Association
www.pharmacists.ca/
References
Bresnihan, B, Alvara-Gracia, JM, Cobby, M, et al. Treatment of rheumatoid arthritis with recombinant human IL-1 receptor antagonist. Arthritis Rheum 1998; 41:2196.
Fleischmann, RM, Schechtman, J, Bennett, R, et al. Anakinra, a recombinant human interleukin-1 receptor antagonist (r-metHuIL-1ra), in patients with rheumatoid arthritis: A large, international, multicenter, placebo-controlled trial. Arthritis Rheum 2003; 48:927.
Last reviewed July 2008 by Jill D. Landis, MD
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