Continuous IV infusion of anakinra

Area of Science:

• Immunology
• Pharmacology
• Critical Care Medicine

Background:

• Cytokine storm is a life-threatening condition characterized by excessive immune system activation.
• Macrophage activation syndrome (MAS) is a severe form of cytokine storm requiring aggressive treatment.
• Current treatment protocols for cytokine storm, especially MAS, are continually evolving.

Purpose of the Study:

• To review the use of continuous intravenous (IV) anakinra for cytokine storm.
• To describe an updated protocol for continuous IV anakinra infusion developed over four years.
• To evaluate the efficacy and advantages of continuous IV anakinra in treating severe cytokine storm.

Main Methods:

• A comprehensive review of published literature on continuous IV anakinra in cytokine storm.
• Summarization of anakinra infusion protocols used in other diseases.
• Analysis of treatment data from approximately 400 patient days of continuous IV anakinra at a US academic medical center.

Main Results:

• Continuous IV anakinra infusion has demonstrated advantages over subcutaneous administration.
• The treatment was primarily used for MAS in adults, showing potential for severe cases.
• The developed protocol facilitates rapid and efficient delivery of anakinra therapy.

Conclusions:

• Continuous IV anakinra infusion is a potentially crucial therapy for severe, life-threatening cytokine storm, including MAS.
• This method may also benefit other conditions like Cytokine Release Syndrome (CRS) post-CAR T-cell therapy.
• Effective treatment delivery relies on close interdisciplinary collaboration among Rheumatology, Pharmacy, and Nursing.