canakinumab: clinical use

Prescribing considerations

• Initiate and supervise through an experienced specialist service.
• Review infection history and vaccination status before treatment; give appropriate non-live vaccinations where indicated.
• Provide the patient alert card and counsel about infection, vaccination, DRESS and macrophage activation syndrome.
• Record product name and batch number for biological traceability.

Contraindications and cautions

• Hypersensitivity to canakinumab or an excipient
• Active severe infection

Monitoring

• Assess for active and latent tuberculosis before initiation and remain alert for symptoms during and after treatment.
• Check white blood cell and neutrophil counts before treatment, early after initiation and periodically during continuing therapy.
• Monitor clinically for infection, hypersensitivity, DRESS and macrophage activation syndrome.
• Consider liver tests and disease-specific inflammatory markers according to clinical context.

Clinical pharmacology

A human IgG1 monoclonal antibody that neutralises IL-1 beta. Subcutaneous bioavailability is approximately 66%, with a mean terminal half-life of about 26 days in adults with CAPS; clearance increases with body weight.

Formulation and product differences

• The selected presentation is a ready-to-use, single-use pre-filled pen.
• The solution requires no reconstitution; it must not be shaken or mixed with other medicines.
• Store refrigerated and protected from light. After removal from refrigeration, follow the product-specific temperature and expiry instructions.

Injection

Route: Parenteral

Strengths: 150 mg, 150 mg/mL