Canakinumab

Canakinumab is an injection used in the treatment of a rare, inherited disease of the immune system.

Overview

The Canakinumab injection is used to treat a rare, inherited disease of the immune system. Cryopyrin-associated periodic syndroms (CAPS), familial cold auto-inflammatory syndrome (FCAS) and Muckle-Wells syndrome (MWS) can all be treated by the Canakinumab injection.

CAPS occurs when the body produces interleukin-1 beta in too great of a volume. This chemical causes inflammation and in patients suffering from CAPS it may cause a fever, headache, rash, joint pains, muscle pains, unusual tiredness or unusual weakness.

The injection of Canakinumab helps to prevent the inflammation from occurring by preventing the proper effect of interleukin-1 beta in the body.

This injection can also be used in the treatment of children with other auto-inflammatory periodic fever syndromes. Other syndromes it can be used to treat can include:

  • Tumor necrosis factor receptor-associated periodic syndrome (TRAPS)
  • Hyperimmunoglobulin D syndrome (HIDS)
  • Mevalonate kinase deficiency (MKD)
  • Familial Mediterranean Fever (FMF)
  • Active systemic juvenile idiopathic arthritis (SJIA)

This medicine should only be used under direct supervision of a doctor in a hospital environment.

This medication is available as a powder, which can be rehydrated into a solution for injection.

This medication can increase the risk of developing cancer in the future.

Conditions treated

  • Cryopyrin-associated periodic syndrome (CAPS)
  • Familial cold auto-inflammatory syndrome (FCAS)
  • Muckle-Wells syndrome (MWS)
  • Tumor necrosis factor receptor-associated periodic syndrome (TRAPS)
  • Hyperimmunoglobulin D syndrome (HIDS)
  • Mevalonate kinase deficiency (MKD)
  • Familial Mediterranean Fever (FMF)
  • Active systemic juvenile idiopathic arthritis (SJIA)

Type of medicine

  • Anti-inflammatory

Side Effects

Alongside the desired effects from use of this medication, some unwanted side effects may also occur. In cases where they occur medical attention may be required.

If any of the following common side effects are experienced you should contact your doctor immediately:

  • Body aches or pain
  • Chills
  • Congestion
  • Coughing
  • Diarrhea
  • Dryness or soreness of the throat
  • Feverishness
  • Headaches
  • Hoarseness
  • Joint pains
  • Loss of hunger
  • Muscle aches and pains
  • Nausea
  • Shivering when warm
  • Shortness of breath
  • Sneezing
  • Stuffy, blocked or a runny nose
  • Sweating when cold
  • Tender or swollen glands in the neck
  • Tightness across the chest
  • Trouble sleeping
  • Trouble swallowing
  • Unusual tiredness
  • Unusual weakness
  • Voice changes in pitch or tone
  • Vomiting

Other side effects can occur that will not require you to seek medical attention. If you do, however, find these side effects bothersome or if they are ongoing then you can inform your medical professional and they may be able to help you to alleviate the effects. Ask your healthcare professional if you have any questions about the side effects. The following common side effects would not usually necessitate a medical response:

  • Abdominal or stomach pains
  • Dizziness
  • Lightheadedness
  • Feeling that surroundings are constantly moving
  • Increase in weight
  • Muscle or bone pain
  • Sensation of spinning
  • Unusual weakness

Common effects at the site of injection include:

  • Bleeding
  • Blistering
  • Burning
  • Feeling of coldness
  • Discoloration
  • Feeling of pressure
  • Hive
  • Inflammation
  • Infection
  • Scarring
  • Itching
  • Lumps
  • Numbness
  • Pain
  • Redness
  • Rash
  • Stinging
  • Swelling
  • Tenderness
  • Tingling
  • Warmth
  • Ulceration

Other side effects that have not been listed herein may occur. In cases where other side effects occur you should inform your doctor if you are concerned about them.

Dosage

This medication is to be administered to you or your child in a hospital or clinic only. The medication is given as a subcutaneous injection that goes just beneath the skin.

This medication is given once every eight weeks to people suffering from CAPS and every four weeks for those suffering from TRAPS, HIDS/MKD, FMF and SJIA.

This medication will be given with a medication guide. You should make sure you read and understand this medication guide before taking the treatment.

The following information is a guideline only. Your doctor will determine the correct dose for your treatment.

The dose of medication given will depend on the syndrome that the patient is suffering from, their weight and other factors. If the patient weighs 40kg or less then the drug manufacturer should be contacted to determine the appropriate dose.

The usual dose administered to a patient is 150 mg. A dose of 300 mg should not be exceeded where this can be avoided.

Interactions

Interaction between medications can occur when you are using more than one at the same time. This medication should not be used in conjunction with any other medications until you have discussed this with your doctor. You should inform your doctor of any medications that you have taken recently or are currently taking before having this treatment. This includes medications that are available over the counter, herbal remedies and vitamin supplements. When taking certain medications your doctor may need to change the dose or may not be able to administer this treatment at all.

Other medical conditions can also interact with this treatment. In some cases, medications can make other medical conditions worse so it is important that you inform your doctor of any and all medical conditions that you have or have had in the past. This is particularly important with the following medical conditions, which may all be worsened by use of this treatment:

  • A history of Hepatitis B
  • A history of Hepatitis C
  • Immune system problems including HIV and AIDS
  • Active infections
  • Active or a history of Tuberculosis

Warnings

Before using this medication you should consider the benefits in relation to the risks of using the medicine. The decision of whether or not to take this medication is one for you and your doctor to make together and in doing so you should consider the following:

Allergies – Your doctor needs to know if you have any allergies to medications. Allergies to medications can result in severe reactions when getting treatment with this medication. You should inform your doctor if you have any other allergies to dyes, preservatives, foods, animals or other substances that you know of.

Pediatric – Safety and efficiency have not been determined in the treatment of CAPS, FCAS or MWS in children younger than 4 years of age. Safety and efficiency has not been determined in the treatment of SJIA in children younger than 2 years of age.

Geriatric – No age-related limitations have been determined in the use of Canakinumab.

Breastfeeding – The risks of breastfeeding whilst using this medication are unknown. Discuss the risks in relation to the benefits with your doctor.

Pregnancy – It is not known whether this drug can cause fetal harm or affect reproductive capacity in humans. You should discuss the risks of use with your doctor before treatment.

During treatment, you or our child should have regular check-ups with the doctor to ensure that the treatment is working effectively.

Before taking this medication you will need to undergo a test for Tuberculosis. If anyone in your household has ever tested positive for Tuberculosis then it is important that you inform your doctor of this fact. Use of this treatment in patients who have had Tuberculosis in the past can cause it to return.

Your body will be less able to fight off infection while you are receiving this treatment. As such it is very important that you react quickly to signs of infection and inform your doctor right away. If you experience the following signs of infection while having this treatment you will need to see a doctor straight away:

  • Fever
  • Chills
  • Coughing
  • Hoarseness
  • Back pain
  • Side pain
  • Painful urination
  • Difficulty urinating

Using this medication can increase your risk of developing cancer in the future. You should discuss these risks with your doctor before using the treatment.

Do not receive any immunizations or vaccinations while taking this treatment. Your lowered immune system may expose you to catching the condition that you are attempting to immunize yourself against. Discuss the immunization with your doctor before you go ahead with it.

This medication can cause the development of macrophage activation syndrome (MAS). This is a life-threatening condition and must be treated immediately. If you have a fever that lasts for longer than 3 days then you should immediately contact your doctor.

Do not take any other medication at the same time as this treatment without first discussing the use with your doctor.

Anaphylaxis may occur at the point of injection. Assess the condition of the patient to ensure anaphylaxis is not occurring before releasing the patient.

Storage

Store the vial of powder at 2-8 °C. Do not allow medication to freeze.

After reconstitution vials can be stored at 2-8 °C for 4 hours or at room temperature for 1 hour. Discard any of the mediation that is not used.

Dispose of medication properly.

Summary

Canakinumab is used in the treatment of a wide range of syndromes. Treated syndromes include:

  • Cryopyrin-associated periodic syndroms (CAPS)
  • Familial cold auto-inflammatory syndrome (FCAS)
  • Muckle-Wells syndrome (MWS)
  • Tumor necrosis factor receptor associated periodic syndrome (TRAPS)
  • Hyperimmunoglobulin D syndrome (HIDS)
  • Mevalonate kinase deficiency (MKD)
  • Familial Mediterranean Fever (FMF)
  • Active systemic juvenile idiopathic arthritis (SJIA)

The Canakinumab injection is given to the patient by injection directly under the skin. It should only be given by a doctor, in a hospital or clinic, at 4-8 week intervals depending on the condition being treated.

The Canakinumab injection is used to block the effectiveness of interleukin-1 beta in the body. This chemical causes inflammation and is blocked in cases where it is too prevalent in the body.

Canakinumab causes serious side effects in some cases and should not be used in people who have certain medical conditions affecting the immune system. This is because the medication itself will lower the immune system in the patient and will leave them exposed to infection. Signs of infection should thus be treated seriously when receiving this treatment and any signs of infection should be reported to your doctor.

Use of this medication can also increase the risk of developing cancer in the future. You should discuss this increased risk with your doctor before beginning treatment.

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Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017
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