Avoid Mishaps With Anakinra Orders for COVID-19

You may hear about using anakinra (Kineret) to treat patients admitted with COVID-19...due to a recent emergency use authorization.

This biologic is usually used for rheumatoid arthritis...and considered an outpatient med.

But now anakinra is authorized for certain adults with SARS-CoV-2 at risk of progressing to severe respiratory failure.

Don’t expect your COVID-19 protocols to change yet.  When a steroid add-on is needed, expect orders for IV tocilizumab (Actemra) or oral baricitinib (Olumiant).  These have stronger evidence for reducing mortality.

But be ready to avoid mishaps if anakinra is ordered for COVID-19...such as if there’s a shortage of preferred meds.

Anticipate getting orders for 100 mg subcutaneously daily...or every other day for certain patients with reduced kidney function.  A full course of treatment with anakinra is 10 days total.

Keep in mind that anakinra comes in 100 mg prefilled syringes...and won’t require prep.

Ensure these are kept in the fridge.  Improper storage could lead to waste...and each syringe costs about $170.

Review our resource, Treatments of Interest for COVID-19, for a deeper dive into meds that might be ordered.

Key References

  • https://www.fda.gov/media/163075/download
  • Nat Med. 2021 Oct;27(10):1752-1760
  • PLoS One. 2022 Aug 4;17(8):e0269065
  • Medication pricing by Elsevier, accessed Dec 2022
Hospital Pharmacy Technician's Letter. January 2023, No. 390122

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