Canakinumab

Canakinumab Brand Name– Ilaris

What is Canakinumab

Canakinumab is a human monoclonal antibody against interleukin (IL)-1 beta approved for the treatment of 2 forms of cryopyrin-associated periodic syndromes (CAPS), Familial Cold Autoinflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS), in patients 4 years of age and older.

Canakinumab is also approved for adult and pediatric patients for Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPS), Hyperimmunoglobulin D Syndrome (HIDS)/Mevalonate Kinase Deficiency (MKD), and Familial Mediterranean Fever (FMF). In addition, canakinumab is approved for active Still’s disease, including Adult-Onset Still’s Disease (AOSD) and Systemic Juvenile Idiopathic Arthritis (SJIA) in patients 2 years of age and older.

Most patients with FCAS and MWS respond positively to canakinumab. For example, 34 of 35 patients who received a single 150 mg canakinumab subcutaneous dose had a complete response, which was defined as a physician global assessment of no or minimal disease activity, an assessment of no or minimal rash, and a C-reactive protein and serum amyloid A protein concentration less than 10 mg/L.

The patient without a complete response had self-injected the drug and had substantially lower than expected canakinumab concentrations.

Continued remission was achieved by all patients who received canakinumab every 8 weeks through week 24.

Indications

  1. coronavirus disease 2019 (COVID-19)
  2. cryopyrin-associated periodic syndromes (CAPS)
  3. familial mediterranean fever
  4. hyperimmunoglobulin D syndrome
  5. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
  6. Still’s disease
  7. systemic juvenile idiopathic arthritis
  8. tumor necrosis factor receptor associated periodic syndrome

For the treatment of Cryopyrin-Associated Periodic Syndromes (CAPS), including Familial Cold Autoinflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS)

Side Effects

  1. abdominal pain
  2. antibody formation
  3. cough
  4. diarrhea
  5. elevated hepatic enzymes
  6. headache
  7. hyperbilirubinemia
  8. hypotension
  9. immunosuppression
  10. infection
  11. influenza
  12. injection site reaction
  13. leukopenia
  14. macrophage activation syndrome
  15. musculoskeletal pain
  16. nausea
  17. neutropenia
  18. new primary malignancy
  19. palpitations
  20. pharyngitis
  21. pruritus
  22. rash
  23. rhinitis
  24. sinusitis
  25. thrombocytopenia
  26. urticaria
  27. vertigo
  28. weight gain

Monitoring Parameters

  • tuberculin skin test

Contraindications

  • breast-feeding
  • children
  • hepatic disease
  • hepatitis
  • human immunodeficiency virus (HIV) infection
  • immunosuppression
  • infants
  • infection
  • neonates
  • neoplastic disease
  • pregnancy
  • renal impairment
  • tuberculosis
  • vaccination

Interactions

  • Alfentanil
  • Anakinra
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Baricitinib
  • Basiliximab
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Brodalumab
  • Caffeine; Ergotamine
  • Carbamazepine
  • Cisapride
  • Cyclosporine
  • Daclizumab
  • Dextromethorphan; Quinidine
  • Dihydroergotamine
  • Ergotamine
  • Ethosuximide
  • Everolimus
  • Fentanyl
  • Fosphenytoin
  • Guselkumab
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Ixekizumab
  • Live Vaccines
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Phenytoin
  • Pimozide
  • Quinidine
  • Rilonacept
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Sarilumab
  • Secukinumab
  • Siltuximab
  • Sirolimus
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Tacrolimus
  • Theophylline, Aminophylline
  • Thioridazine
  • Tildrakizumab
  • Tizanidine
  • Tocilizumab
  • Tofacitinib
  • Tumor Necrosis Factor modifiers
  • Typhoid Vaccine
  • Upadacitinib
  • Ustekinumab
  • Varicella-Zoster Virus Vaccine, Live
  • Warfarin
  • Yellow Fever Vaccine, Live
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