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Published on: January 31, 2020
Anakinra for rheumatoid arthritis.
Marty Mertens1, Jasvinder A Singh
1University of Minnesota, 596 Grand Ave., Apt 1, Saint Paul, Minnesota 55102, USA. mtm7575@yahoo.com
The Cochrane Database of Systematic Reviews
|January 23, 2009
Summary
Anakinra (interleukin-1 receptor antagonist) offers modest clinical benefits for rheumatoid arthritis (RA) patients, showing improved ACR20 scores. While generally safe, injection site reactions are common, and long-term safety data requires further evaluation.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Biologics targeting cytokines have advanced rheumatoid arthritis (RA) treatment.
- Anakinra, an interleukin-1 receptor antagonist, is FDA-approved for RA unresponsive to DMARDs.
Purpose of the Study:
- To evaluate the clinical effectiveness and safety of anakinra in adult patients with rheumatoid arthritis.
Main Methods:
- Systematic review of randomized controlled trials comparing anakinra to placebo or other treatments.
- Searched multiple electronic databases including Cochrane, MEDLINE, EMBASE, and CINAHL.
- Two independent reviewers assessed trial quality and extracted data.
Main Results:
- Anakinra (50-150 mg daily) significantly improved ACR20 scores (38% vs 23%) compared to placebo after 24 weeks.
- Other efficacy measures (ACR50, ACR70, HAQ, VAS, Larsen scores, ESR) also showed significant improvement with anakinra.
- No statistically significant differences in overall safety outcomes, but significantly increased injection site reactions (71% vs 28%) and a trend towards higher serious infections with anakinra.
Conclusions:
- Anakinra is a modestly effective and relatively safe biologic therapy for RA.
- Efficacy appears less than other biologics, and head-to-head trials are lacking.
- Further research is needed on comparative efficacy, long-term safety, and adverse event profiles.
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