# Anakinra

Source: https://onco.cc/drugs/anakinra/  
OnCo record `anakinra` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Anakinra is an anti-inflammatory injection approved for arthritis and rare inflammatory diseases. After CAR-T cell therapy it is used to calm a severe inflammatory reaction (IEC-HS) and as a third-line option when cytokine release syndrome does not settle.

## Summary

The Kineret label covers rheumatoid arthritis, neonatal-onset multisystem inflammatory disease (a cryopyrin-associated periodic syndrome) and deficiency of the interleukin-1 receptor antagonist. In the ASTCT consensus on immune effector cell-associated HLH-like syndrome (Hines 2023), "Anakinra was recommended as a first-line agent", and "Therapy should generally be initiated with corticosteroids +/− anakinra prior to development of life-threatening complications". SITC 2020 says that if cytokine release syndrome does not improve after two doses of tocilizumab and steroids, third-line agents including anakinra, siltuximab and high-dose methylprednisolone should be considered (level of evidence 4). Its use in these settings is off-label. The BLA was first approved on 14 November 2001.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: Kineret
- Modality: Interleukin-1 receptor antagonist (recombinant protein, injection)
- Mechanism: A recombinant interleukin-1 receptor antagonist that blocks IL-1 signalling.
- Approvals: US 2001: Rheumatoid arthritis; neonatal-onset multisystem inflammatory disease; deficiency of interleukin-1 receptor antagonist

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Anakinra
- US label (DailyMed): Kineret: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d9d74915-6606-4570-9c52-c4001d3177de
- Hines et al., Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (ASTCT, Transplant Cell Ther 2023): https://doi.org/10.1016/j.jtct.2023.03.006
- Maus et al., SITC clinical practice guideline on immune effector cell-related adverse events (J Immunother Cancer 2020): https://doi.org/10.1136/jitc-2020-001511

## Connected records

- drugs: [Tocilizumab](https://onco.cc/drugs/tocilizumab/)
- technologies: [CAR-T cell therapy](https://onco.cc/technologies/car-t/)
- terms: [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/), [IEC-HS (immune effector cell-associated HLH-like syndrome)](https://onco.cc/terms/iec-hs/)

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