Canakinumab

Information about Canakinumab

Canakinumab bound to IL-1β

Canakinumab is a monoclonal antibody to interleukin-1 (IL-1) beta which is used in the therapy of juvenile idiopathic arthritis and other autoinflammatory conditions.

Canakinumab is a relatively new biologic agent, has had limited clinical use, but has yet to be linked to cases of clinically apparent, acute liver injury.

Mechanism of action of Canakinumab

• Canakinumab (kan” a kin’ ue mab) is a human monoclonal antibody to IL-1 beta.
• The antibody reactivity is specific for IL-1 beta with no cross reactivity to other members of the IL-1 family or other cytokines.
• IL-1 is a key proinflammatory cytokine that medicates local and systemic inflammatory reactions and can induce fever, pain sensitization, bone and cartilage destruction and acute phase plasma protein reactions.
• In several controlled trials and open label studies, canakinumab has been shown to improve symptoms and laboratory abnormalities associated with juvenile idiopathic arthritis (formerly juvenile rheumatoid arthritis or Still disease) and several rare autoinflammatory conditions such as cryopyrin associated periodic syndrome (CAPS), Schnitzler syndrome and familial Mediterranean fever.

FDA approval information for Canakinumab

Canakinumab was approved for use in periodic fever syndromes in the United States in 2009 and indications were expanded to include juvenile idiopathic arthritis in 2013.

Dosage and administration for Canakinumab

• Canakinumab is considered a disease modifying antirheumatic drug (DMARD), and improves signs and symptoms of disease and decreases cartilage and tissue destruction.
• For juvenile idiopathic arthritis, canakinumab is given by subcutaneous injection every 8 weeks in a dose of 4 mg/kg (for patients weighing >7.5 kg) with a maximum dose of 300 mg.
• Lower doses are used in cryopyrin associated periodic syndromes.

Side effects of Canakinumab

The most frequent side effects are local skin reactions, gastrointestinal upset, diarrhea, vertigo and possibly an increased incidence of bacterial infections.

antirheumatic agents

• gold preparations
  • auranofin, gold salts, gold sodium thiomalate

• interleukin receptor antagonists
  • anakinra, canakinumab, rilonacept, sarilumab, tocilizumab

• major immunosuppressive agents (also used in transplant medicine)
  • cyclosporine, mycophenylate, sirolimus, tacrolimus

• monoclonal antibodies
  • adalimumab, canakinumab, certolizumab, golimumab, infliximab, rituximab, sarilumab, tocilizumab, ustekinumab

• thiopurines
  • azathioprine, mercaptopurine, thioguanine

• tumor necrosis factor antagonists
  • adalimumab, certolizumab, etanercept, golimumab, infliximab

• tyrosine (janus) kinase inhibitors
  • baricitinib, tofacitinib

• miscellaneous
  • abatacept, flavocoxid, hydroxychloroquine, leflunomide, methotrexate, penicillamine

• Dailymed label info on Canakinumab
• FDA Canakinumab