canakinumab at a glance
Medicine class
Monoclonal antibody and interleukin inhibitor
Main roles
Periodic fever syndromes, Still’s disease and selected cases of gouty arthritis
Administration
Subcutaneous injection using a single-use pre-filled pen
Oversight
Treatment is initiated and supervised by an appropriately experienced specialist
What is canakinumab used for?
UK-licensed uses represented by this product include:
Cryopyrin-associated periodic syndromes, including Muckle–Wells syndrome, NOMID/CINCA and severe FCAS/FCU
Tumour necrosis factor receptor-associated periodic syndrome
Hyperimmunoglobulin D syndrome/mevalonate kinase deficiency
Familial Mediterranean fever
Active adult-onset Still’s disease and systemic juvenile idiopathic arthritis after inadequate response to previous therapy
Frequent gouty arthritis attacks in selected adults when NSAIDs or colchicine are unsuitable or ineffective and repeated corticosteroid treatment is inappropriate
How does canakinumab work?
Canakinumab binds to interleukin-1 beta and prevents it from activating its receptor. This reduces inflammatory signalling involved in fever, rash, joint inflammation and other manifestations of IL-1-driven disease.
canakinumab preparations and strengths
Injection
Route: Parenteral
Strengths: 150 mg, 150 mg/mL
How to take canakinumab
Canakinumab is injected under the skin. Use the pre-filled pen only after training and if the specialist agrees that self-administration or caregiver administration is appropriate.
Suitable areas include the thigh, abdomen, upper arm or buttock; rotate injection sites.
Avoid broken, bruised, scarred or rash-covered skin.
Do not shake or reuse the pen.
Let the unopened carton reach room temperature, then inspect the liquid. Do not use it if it contains visible particles or is distinctly brown.
Dispose of the used pen in an appropriate sharps container.
canakinumab side effects
Common or expected effects
- Respiratory, ear, skin, stomach or urinary infections
- Injection-site reactions
- Upper abdominal pain or joint pain
- Dizziness, musculoskeletal pain or fatigue
- Reduced white blood cell counts
- Changes in kidney-function tests
Get urgent medical advice
- Serious or opportunistic infection
- Severe allergic reaction
- DRESS: widespread rash, sometimes with fever, swollen glands or skin peeling
- Macrophage activation syndrome in people with Still’s disease
- Marked neutropenia or leukopenia
canakinumab in pregnancy
Pregnancy experience is limited. Treatment should be considered only after specialist assessment of maternal disease and potential risks. Discuss pregnancy plans or a positive test promptly rather than stopping treatment independently. Effective contraception is recommended during treatment and for three months afterwards. Tell the baby’s healthcare professional about exposure before birth because it affects live-vaccine planning.
canakinumab while breastfeeding
It is unknown whether canakinumab enters human milk, so an individual benefit–risk assessment is recommended. UK rheumatology guidance considers IL-1 inhibitors compatible with breastfeeding on limited evidence, but specialist advice is particularly important for a newborn or premature infant.
canakinumab interactions
Formal interaction studies are limited. Important considerations include:
Tumour necrosis factor inhibitors
Concurrent use is not recommended because serious infection risk may increase.
Live attenuated vaccines
Avoid concurrent administration unless a specialist determines that the benefit outweighs the risk.
Narrow-therapeutic-index CYP450 substrates
Reduced inflammation may restore CYP450 activity and alter drug exposure, so effect or concentration monitoring may be needed when canakinumab begins.
Common questions about canakinumab
Answers are fully visible for fast scanning and source review.
What type of treatment is canakinumab?
It is a biological immunomodulator: a human monoclonal antibody that specifically blocks interleukin-1 beta.
Can I have vaccines while taking canakinumab?
Non-live vaccines can generally be considered, but live vaccines require specialist planning and are normally avoided during treatment. Discuss vaccinations before receiving them.
Can canakinumab be self-injected?
Some people with periodic fever syndromes or Still’s disease, or their caregivers, may use the pen after training and specialist approval. For gouty arthritis, it is administered by a healthcare professional.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.