Canakinumab

INTRODUCTION

Indications

Treatment of cryopyrin-associated periodic syndromes (CAPS) including familial cold autoinflammatory syndrome (FCAS) an Muckle-Wells syndrome (MWS).

Action

Binds and neutralizes the activity of excess interleukin associated with CAPS. Therapeutic Effects: Decreased symptoms of CAPS, including fever, urticaria-like rash, arthralgia, myalgia, fatigue, and conjunctivitis.

Adverse Reactions/Side Effects

CNS: headache, vertigo. EENT: nasopharyngitis. Resp: bronchitis. GI: diarrhea, nausea, gastroenteritis. Local: injection site reactions. Metab: weight gain. MS: musculoskeletal pain. Misc: Increased risk of serious infections/reinfections, influenza.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Report any signs of infection, especially pulmonary signs associated with pneumonia, influenza, and invasive fungal infections. Common pulmonary signs of infection include persistent cough, dyspnea, chest pain, coughing up blood, fatigue, fever, chills, and loss of appetite.

• Periodically assess impairments such as joint pain, muscle aches, fatigue, skin rash, and conjunctivitis to help document whether drug therapy is successful in treating CAPS and related syndromes.

• Assess any new bone or muscle pain to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic and biomechanical problems.

• Periodically assess body weight and other anthropometric measures (body mass index, body composition). Report a rapid or unexplained weight gain or increased body fat.

• Monitor IV injection site for pain, swelling, and irritation. Report prolonged or excessive injection-site reactions to the physician.

Patient/Client-Related Instruction

• Instruct patient to guard against infection (frequent hand washing, etc.), and to avoid crowds and contact with persons with contagious diseases.

• Instruct patient to report other troublesome side effects including severe or prolonged headache, vertigo, irritation of the nose and pharynx, or GI problems (nausea, diarrhea, abdominal pain).

Pharmacokinetics

Absorption: 70% absorbed following SCs administration.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: 26 days.

Contraindications/Precautions

Contraindicated in: None noted.

Use Cautiously in: Active untreated infection, history of recurrent infections or conditions increasing the propensity of infections; OB: Use during pregnancy only if clearly needed; Lactation: Use cautiously during lactation; Pedi: Safety and effectiveness in children <4 yr has not been established.

Interactions

Drug-Drug: Avoid concurrent use of live vaccines; all vaccinations should be completed prior to treatment; Concurrent use with tumor ...