阿那白滯素

Safety

It was not tested in pregnant women, but appeared to be safe in animal studies.[3]

It should not be used in people who have active infections or latent tuberculosis, who have low 白血球 counts, or who are taking TNF inhibitors.[3]

Adverse effects

More than ten percent of people taking Anakinra have injection site reactions, headaches, and have increased cholesterol levels.[2] Between one and ten percent of recipients have severe infections, decreased white blood cells, or decreased 血小板.[2] It is unclear if taking Anakinra increases cancer risk; studies are complicated by the fact that people with rheumatoid arthritis already face higher cancer risk.[2][4]

Chemistry

Anakinra differs from the sequence of Interleukin 1 receptor antagonist by one 甲硫氨酸 氨基酸 added to its N端; it also differs from the human protein in that it is not 醣基化, as it is 工业发酵 in 大腸桿菌.[3]

History

It was approved for medical use in the US in 2001,[3] and in the European Union in 2002.[2][1]

In 2018, NHS England published a Clinical Commissioning Policy: Anakinra to treat periodic fevers and autoinflammatory disorders (all ages) allowing Anakinra to be commissioned as a first-line treatment for Schnitzler's syndrome and in cases where the first-line treatment is not effective for Familial Mediterranean fever, Hyper-IgD syndrome also known as Mevalonate kinase deficiency, and TNF receptor associated periodic syndrome (TRAPS),[12] and a Clinical Commissioning Policy: Anakinra/tocilizumab for the treatment of Adult-Onset Still's Disease refractory to second-line therapy (adults), allowing Anakinra to be commissioned for adult-onset Still's disease "as a third line treatment where patients are refractory to steroid-sparing effect DMARDs".[13]

In December 2020, Anakinra was approved by the US Food and Drug Administration for the treatment of deficiency of the interleukin-1–receptor antagonist (DIRA), a rare autoinflammatory disease of infancy.[14] In 2021, it was announced that the 俄罗斯联邦卫生部 had approved the use of Anakinra for the treatment of CAPS.[15]

In October 2021, NHS England published Clinical Commissioning Policy: Anakinra for Haemophagocytic Lymphohistiocytosis (HLH) for adults and children in all ages, allowing Anakinra to be used in the treatment of HLH.[16]

Society and culture

Research

Anakinra effectively treated meningitis caused by a rare genetic mutation in the gene NALP3 in a 67-year-old man enrolled in the Undiagnosed Diseases Network.[17] Researchers at 约翰斯·霍普金斯大学 announced in 2019 that anakinra given to pregnant mice with 茲卡病毒 had reduced fetal deaths and birth defects.[18] In November 2019, researchers at the 曼彻斯特大学 reported that Anakinra might have a use in preventing breast cancer from spreading to the bones.[19][20]

In 2021, it was reported that Anakinra appeared to reduce the 神經性疼痛 experienced by patients undergoing 化学疗法 with 长春新碱, saying that "repurposing anakinra may be an effective co-treatment strategy to prevent vincristine-induced peripheral neuropathy".[21][22]

A review published in 2022 found that "Anakinra appears to show efficacy for numerous 皮肤病学 conditions, with the strongest evidence for hidradenitis suppurativa, 貝賽特氏症, Muckle–Wells syndrome, and SAPHO syndrome." and concluded that "Overall, anakinra appears to be a promising option in the treatment of numerous dermatologic inflammatory conditions refractory to first line therapies, but further and higher-quality data is needed to clarify its therapeutic role."[23]

In 2023, researchers at 哥伦比亚大学 explored the effect of Anakinra on the ageing of 造血干细胞s in mice. They concluded "that targeting IL-1 as a key mediator of niche inflammation is a tractable strategy to improve blood production during ageing" and were reported to have said "that their findings could pave the way for science to delay aging and even lengthen the lifespan of humans".[24][25][26]