canakinumab (Ilaris)

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Indications

* no effect of serum cholesterol[4]

Contraindications

Pregnancy category: C[2]

Dosage

  • subcutaneous injection every 8 weeks
  • 150 mg patients with body weight greater than 40 kg
  • 2 mg/kg with body weight 15-40 kg
  • may increase to 3 mg/kg if inadequate response to 2 mg/kg
  • 150 mg every 3 months for 15% cardiovascular risk reduction[4]
    • 300 dose failed to meet prespecified threshold for benefit[4]
    • 50 mg dose not effective[4]
  • 300 mg every 3 months associated with 77% reduction in fatal lung cancer[4]

Sterile, single-use 6-mL, glass vial containing 180 mg of Ilaris lyophilized powder for reconstitution

Monitor

Adverse effects

Mechanism of action

Management

Notes

  • cost of canakinumab U.S. 2017 is ~ $65,000-200,000/year[4]

More general terms

Additional terms

References

  1. Prescriber's Letter 17(2): 2010 New Drugs Approved by the FDA in 2009 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260213&pb=PRL (subscription needed) http://www.prescribersletter.com
  2. Jump up to: 2.0 2.1 2.2 2.3 2.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2022.
  3. Jump up to: 3.0 3.1 Deprecated Reference
  4. Jump up to: 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Wendling p CANTOS: Anti-Inflammatory Drug Cuts CV Events, Cancer Medscape - Aug 27, 2017 http://www.medscape.com/viewarticle/884745
    Ridker PM, Everett BM, Thuren T et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017 Aug 27; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28845751 <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1707914
    Harrington RA. Targeting inflammation in coronary artery disease. N Engl J Med 2017 Aug 27 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28844177 <Internet> http://www.nejm.org/doi/10.1056/NEJMe1709904
  5. Jump up to: 5.0 5.1 Ridker PM, MacFadyen JG, Thuren T, et al Effect of interleukin-1beta inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomised, double-blind, placebo- controlled trial. Lancet. 2017 Aug 25. pii: S0140-6736(17)32247-X. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28855077
  6. Jump up to: 6.0 6.1 Ridker PM, Everett BM, Thuren T et al Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. N Engl J Med 2017; 377:1119-1131. September 21, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28845751 Free full text <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1707914
  7. Jump up to: 7.0 7.1 Wendling P CANTOS: Canakinumab Fails to Prevent New-Onset Diabetes. Medscape - Mar 14, 2018. https://www.medscape.com/viewarticle/893887
  8. Jump up to: 8.0 8.1 De Benedetti F, Gattorno M, Anton J et al Canakinumab for the Treatment of Autoinflammatory Recurrent Fever Syndromes. N Engl J Med 2018; 378:1908-1919. May 17, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29768139 https://www.nejm.org/doi/full/10.1056/NEJMoa1706314
  9. Jump up to: 9.0 9.1 Walsh N IL-1 Blockade Appears Effective Against Gout. Canakinumab lowered the risk of attacks by more than half in post-MI patients. MedPage Today. June 14, 2018 https://www.medpagetoday.com/meetingcoverage/eular/73503
    Solomon D et al Serum urate, gout, and cardiovascular disease in a randomized controlled trial of canakinumab: a CANTOS secondary analysis. European Congress of Rheumatology (EULAR) 2018; abstract OP0014.
  10. NEJM J Watch editors Anti-inflammatory Agent Rejected as Heart Disease Drug. David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  11. Jump up to: 11.0 11.1 Medscape. Aug 14, 2020 FDA Drug Approvals, Internal Medicine - 2020 Midyear Review. https://reference.medscape.com/viewarticle/935373
  12. Jump up to: 12.0 12.1 Schieker M et al. Effects of interleukin-1beta inhibition on incident hip and knee replacement: Exploratory analyses from a randomized, double-blind, placebo-controlled trial. Ann Intern Med 2020 Aug 4; PMID: https://www.ncbi.nlm.nih.gov/pubmed/32744862 https://www.acpjournals.org/doi/10.7326/M20-0527
  13. Jump up to: 13.0 13.1 Caricchio R, Abbate A, Gordeev I et al Effect of Canakinumab vs Placebo on Survival Without Invasive Mechanical Ventilation in Patients Hospitalized With Severe COVID-19. A Randomized Clinical Trial. JAMA. 2021;326(3):230-239 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34283183 https://jamanetwork.com/journals/jama/fullarticle/2782185
  14. Jump up to: 14.0 14.1 Hicks L FDA Approves Canakinumab for Gout Flares. Medscape. August 30, 2023 https://www.medscape.com/viewarticle/995993
  15. HIGHLIGHTS OF PRESCRIBING INFORMATION ILARIS <TM> (canakinumab) for subcutaneous injection https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/ilaris.pdf