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Anakinra can be used alone or in combination with DMARDs other than TNF blocking agents (Etanercept, Infliximab). joint rolling Right side abdominal pain. Anakinra is not recommended for use in combination with TNF inhibitors. Mechanism: Anakinra is recombinant, nonglycosylated form of the human IL-1ra. It differs from the native nonglycosylated IL-1ra by the addition of an N-terminal methionine. joint rolling Viral arthritis. Anakinra blocks the biologic activity of IL-1 by binding to IL-1R type I with the same affinity as IL-1b. Dosage: The recommended dose of anakinra is 100 mg/day administered daily by subcutaneous injection. The dose should be administered at approximately the same time each day. joint rolling Feline-arthritis. Side Effects: The most commonly observed side effect in all of the clinical trials with anakinra to date is injection site reactions, occurring in approximately two-thirds of patients at the FDA-approved daily dose of 100 mg administered subcutaneously. These reactions are generally mild, present as erythema, itching, and discomfort and resolve over one to two months. A modest increase in the risk of serious infection was observed in RA patients treated with anakinra in combination with DMARDS other than TNF inhibitors, compared to placebo with DMARDs (2 % vs 1%). The risk of serious infections of anakinra in combination with a TNF inhibitor is unknown, but preliminary data in a small-uncontrolled study of 58 RA patients suggest an increase (7%) relative to anakinra alone. In the placebo-controlled trials, 8% of patients receiving anakinra had mild to moderate decreases in absolute neutrophil counts, compared to 2% in the placebo groups. 0. 3% of anakinra treated patients experienced severe neutropenia (< 1x 109/L). In the combination anakinra/etanercept study, two of 58 points (3%) experienced severe neutropenia. The rate of malignancies in anakinra treated patients was not increased relative to expected rates in the general population.
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