II. Indications
- Severe active Rheumatoid Arthritis refractory to DMARDs
III. Contraindications
- Chronic or acute infection
- Concurrent use of TNF Antagonists (infection risk)
IV. Mechanism
- Interleukin-1 Receptor Antagonist
V. Dosing
- Adults: 100 mg SC qd with rotating injection sites
VI. Cost
- Vial of 100 mg/0.67 ml (7 doses): $260
VII. Adverse Effects
-
Immunosuppression
- Use caution in any patient prone to infection
- Headache
- Injection site inflammation
- Gastrointestinal upset
- Leukopenia (including Neutropenia)
VIII. Monitoring
- Serum Creatinine
-
Complete Blood Count with Neutrophil Count
- Baseline, then
- Monthly for 3 months, then
- Quarterly
IX. References
- (2003) Lexicomp Drug Database