Canakinumab is administered through a subcutaneous injection. Depending on the condition being treated, the injection can be given either at a clinic or at home after receiving proper training from a healthcare professional.

• Home administration: For patients able to administer the injection themselves, the healthcare provider will demonstrate the proper technique. The injection is usually given into the fatty tissue just under the skin, typically in the thigh, abdomen, or upper arm.
• Administration frequency: The frequency of injections depends on the specific condition being treated. For example, in CAPS, it is usually given once every 8 weeks, while for juvenile arthritis, it is given every 4 weeks.

Preparation and Administration:

• The injection should be administered at room temperature. If the medication has been refrigerated, it should be allowed to warm up before use (usually 30 minutes).
• Follow the instructions provided by the healthcare provider or the medication’s packaging for proper injection techniques.
• The injection site should be rotated to avoid irritation.

• IL-1β Inhibition: Canakinumab works by binding to IL-1β, preventing it from interacting with its receptors and triggering inflammation. This leads to reduced production of inflammatory cytokines and helps decrease the symptoms of diseases caused by excessive inflammation.

Auto-inflammatory Conditions: The drug is effective in treating diseases like Cryopyrin-Associated Periodic Syndromes (CAPS), where an overactive immune response causes severe inflammation. It is also used for Systemic Juvenile Idiopathic Arthritis (SJIA), a condition characterized by chronic inflammation in children.

While canakinumab is generally well-tolerated, it can cause side effects in some patients. The most common side effects include:

• Infections: Since canakinumab suppresses part of the immune system, patients are at higher risk of infections, including respiratory infections and urinary tract infections.
• Injection site reactions: Pain, redness, swelling, or itching at the injection site are common side effects.
• Headache: Some patients may experience headaches during treatment.
• Gastrointestinal symptoms: Nausea or diarrhea can occur, though they are less common.
• Elevated liver enzymes: Some patients may experience elevated liver enzymes, which may require monitoring and dose adjustments.

More serious, though rare, side effects include:

• Serious infections: Patients receiving canakinumab may be at higher risk for serious infections, such as tuberculosis or fungal infections. It’s important for patients to be screened for infections before starting treatment.
• Allergic reactions: Though uncommon, allergic reactions to canakinumab can occur, including symptoms like rash, shortness of breath, or swelling.

Malignancies: Some studies suggest that long-term use of immunosuppressive drugs, like canakinumab, may slightly increase the risk of certain cancers. Regular monitoring is essential.

Canakinumab should be used with caution in certain patient populations and conditions:

• Infections: Canakinumab can increase the risk of infections, and patients should be screened for active infections before starting therapy. If a serious infection develops, treatment should be discontinued until the infection is resolved.
• Tuberculosis: Before starting treatment, patients should be screened for latent tuberculosis (TB). Canakinumab should not be used in patients with active TB.
• Vaccination: Live vaccines should be avoided during treatment with canakinumab. Patients should be up-to-date on vaccinations before starting therapy.
• Pregnancy and breastfeeding: Canakinumab is generally not recommended during pregnancy unless the benefits outweigh the risks. It is unknown whether canakinumab is excreted in breast milk, so caution should be used in nursing mothers.

Heart disease: Although canakinumab has shown some benefits in reducing cardiovascular inflammation, it should be used cautiously in individuals with heart failure or other heart conditions.

• Other biologics and immunosuppressive agents: Canakinumab may increase the risk of infections when used in combination with other immunosuppressive therapies or biologics. Caution is advised when combining it with other agents that target the immune system.
• Vaccinations: Since canakinumab suppresses the immune system, live vaccines should be avoided during treatment. Vaccinations should be given before starting treatment with canakinumab, or if needed, the vaccination schedule should be adjusted.
• Other medications: While no significant drug interactions are known, it is important to inform healthcare providers of all other medications being taken, including over-the-counter drugs and supplements.

The dosage of canakinumab depends on the condition being treated:

• Cryopyrin-Associated Periodic Syndromes (CAPS):
  • Adults: 150 mg subcutaneously every 8 weeks.
  • Children (age 2 and older): Dose based on body weight, typically 2 mg/kg for those under 40 kg, and 150 mg for those over 40 kg, given every 8 weeks.
• Systemic Juvenile Idiopathic Arthritis (SJIA):
  • Children: 4 mg/kg (up to 150 mg) subcutaneously every 4 weeks.
• Gout:
  • Adults: 150 mg subcutaneously every 4 weeks.

Administration Schedule: The drug is administered as an injection, and the frequency varies based on the condition. Regular monitoring of infection risk, liver function, and overall health is necessary.

Canakinumab is a prescription-only medication. A healthcare provider must evaluate the patient’s condition and determine if canakinumab is appropriate based on their medical history and current health status. Patients will need to be monitored regularly for any potential side effects, including infections, liver function, and injection site reactions.

1. What is Canakinumab?

Canakinumab is a monoclonal antibody used to treat various inflammatory conditions, including autoinflammatory diseases like familial Mediterranean fever and systemic juvenile idiopathic arthritis.

2. How does Canakinumab work?

Canakinumab targets and inhibits interleukin-1 beta (IL-1β), a cytokine involved in inflammatory processes, thereby reducing inflammation and the symptoms associated with it.

3. What conditions is Canakinumab approved to treat?

Canakinumab is approved for conditions such as systemic juvenile idiopathic arthritis, adult-onset Still’s disease, cryopyrin-associated periodic syndromes, and certain forms of severe asthma.

4. How is Canakinumab administered?

Canakinumab is typically administered via subcutaneous injection, with dosage and frequency depending on the specific condition being treated.

5. What are the common side effects of Canakinumab?

Common side effects include injection site reactions, headache, nausea, and an increased risk of infections due to immune suppression.

6. Can Canakinumab be used in children?

Yes, Canakinumab is approved for use in children with specific inflammatory conditions like systemic juvenile idiopathic arthritis.

7. What should I tell my doctor before starting Canakinumab?

Inform your doctor about any existing health conditions, allergies, and medications you’re currently taking, including over-the-counter drugs.

8. Are there any contraindications for Canakinumab?

Canakinumab should not be used in individuals with a known hypersensitivity to the drug or its components, and caution is advised in patients with active infections.

9. Can Canakinumab be used during pregnancy?

The effects of Canakinumab during pregnancy are not well-studied, so it should only be used if the potential benefits outweigh the risks, under a doctor’s guidance.

10. How long does it take for Canakinumab to start working?

Patients may start to see improvements in symptoms within a few weeks, but it can vary based on the condition and individual response.

11. What monitoring is needed while on Canakinumab?

Regular monitoring may be necessary to check for infections, blood counts, and overall response to treatment.

12. Can Canakinumab interact with other medications?

Yes, Canakinumab may interact with other medications, especially those that suppress the immune system. Always discuss your current medications with your doctor.

13. What should I do if I miss a dose of Canakinumab?

If you miss a dose, contact your healthcare provider for advice on when to take the missed dose or if you should skip it.

14. Is Canakinumab approved for conditions beyond inflammation?

Currently, Canakinumab is primarily indicated for inflammatory conditions. However, research is ongoing into its effects on other diseases.

15. What are the differences between Canakinumab and other IL-1 blockers?

Canakinumab differs from other IL-1 blockers in its specific mechanism of action and its targeted indications for different inflammatory diseases.

16. How much does Canakinumab cost?

The cost of Canakinumab can vary significantly based on insurance coverage, location, and the prescribed dosage. Patients should check with their insurance provider for specific information.

17. Can I receive vaccinations while on Canakinumab?

Live vaccines should generally be avoided while on Canakinumab, and you should consult a healthcare provider regarding vaccinations.

18. How is Canakinumab stored?

Canakinumab should be refrigerated and protected from light. Once taken out for an injection, it can be kept at room temperature for a limited time.

19. What should I do if I experience severe side effects?

If you experience severe side effects, such as difficulty breathing, swelling, or signs of infection, seek immediate medical attention.

20. Where can I find more information about Canakinumab?

For more detailed information, you can consult resources like the FDA, your healthcare provider, or official medical websites that provide extensive drug information.