Patient ID

Some RA patients don’t fit the standard profile.

Identifying an autoinflammatory component in your patient’s RA is a multifactorial process. However, a few general criteria may provide some important context.

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Find out if your patient is right for Kineret® (anakinra).

Just answer these 4 simple questions.

If you have a patient with difficult-to-treat RA, this 60-second survey may help you determine whether he or she is suitable for Kineret.

PP-5625 Begin
  • 1
    Steroid Response
  • 2
    Treatment History
  • 3
    Signs & Symptoms of Inflammation
  • 4
    Acute Phase Reactants
  • Results

Has your patient been prescribed steroids?

Does your patient have persisting inflammatory symptoms despite steroid treatment?

Has your patient tried and failed any treatments within the following therapy classes? Check all that apply.

How many signs and symptoms of extra-articular inflammation has your patient experienced? Check all that apply.

Has your patient exhibited any other potential indicators, such as elevated CRP or ESR levels?

Kineret candidates typically try and fail steroids, DMARDs, and anti-TNFs before initiating therapy, although this isn’t always the case.1, 3, 5

While Kineret may not be right for your patient at this time, it is important to understand the signs and symptoms of interleukin-1 (IL-1)—driven inflammation for future consideration1-5:

  • Steroid resistance
  • Lack of response to DMARDs and anti-TNFs
  • Extra-articular signs and symptoms, such as fever, rash, headache, fatigue, muscle-related symptoms, keratoconjunctivitis sicca or dry eyes
  • Elevated acute phase reactants (CRP and ESR)

Your patient might be right for Kineret

Based on your answers, your patient’s RA might be mediated by interleukin-1 (IL-1), which could mean he or she is a candidate for Kineret.3

Steroid resistance, lack of response to DMARDs/anti-TNFs, extra-articular evidence of inflammation, or elevated CRP or ESR can be signs of IL-1–driven autoinflammation.1-5

To refer your patient for Kineret treatment, download our referral form.

See how these criteria fit into three real-life examples of difficult-to-treat RA.

A patient’s perspective.

Megan has been treating her multidrug-resistant RA with Kineret® (anakinra) since 2013.

“Compared to how I felt when I was diagnosed, and during the five years after, the change is heartening.” — Megan

Signs of Inflammation

  • Severe, polyarticular joint pain
  • Severe rash (vasculitis), initially on legs and spreading
  • Fatigue
  • Fever

“These years hold some of the darkest moments of my life. I ‘failed’ one drug after another. I started slowly losing my hair, my independence, and my optimism for a future without pain.”

Treatment Failures

August 2011, aged 31:

  • Treatment initiated with NSAIDs, corticosteroids, and a traditional DMARD

2011-2013:

  • Trials with 2 additional traditional DMARDs failed
  • Symptoms partially managed with NSAIDs, corticosteroids, and original DMARD

“In my case, since beginning treatment with Kineret, the joints in my hands and my feet became less tender and painful. It has also helped control my frequent low-grade fevers, and my skin rashes have improved.”

Treatment With Kineret

June 2013:

  • Treatment with Kineret initiated based on symptom profile
  • Megan continued to receive corticosteroids and traditional DMARD

September 2013:

  • Megan reports noticeable improvement in joint pain, fever, and rash

2019:

  • Megan continues treatment with Kineret

This case represents one patient’s experience. Individual results may vary.

Date NOTES
  • Spring 2011
    • Referred to rheumatologist for
      joint pain, rash, and fever
  • August 2011
    • Diagnosed with RA
    • Treated with NSAIDs,
      corticosteroids, and traditional
      DMARD
    Trials with 2 additional DMARDs
  • June 2013
    • Started Kineret treatment
  • 2019
    • Continues Kineret treatments

A clinical case study.

Dr. Edward Ewald relays his case of a male patient with
difficult-to-treat RA , initially diagnosed at age 49.

“The patient’s symptoms definitely improved on Kineret.... He’s not had any complaints of painful joints. He’s been under relatively good control.” — Dr. Ewald

Physician Edward Ewald, MD Adult rheumatologist Patient 49-year-old male

Symptoms

  • Moderately severe joint pain
  • Swelling and tenderness of multiple PIP and MCP joints, MTP joints, shoulders, and knees:
    • Swollen joint count: 8
    • Tender joint count: 8
  • Symmetrical polyarthritis affecting large and small joints
  • One hour of morning stiffness
  • Difficulty with day-to-day functioning
  • Positive rheumatoid factor
  • Erythrocyte sedimentation rate (ESR) of 115

Diagnosis

Rheumatoid arthritis

Treatment history

Prednisone, hydroxychloroquine

Tapers prednisone, adds nabumetone

Adds methotrexate

Initial biologic with treatment failure

Kineret® (anakinra)

“We talked about Kineret because it had a very short half-life.”

Complicating Conditions

  • Poststreptococcal glomerulonephritis
  • Successful renal transplant
  • Current osteoarthritis at age 73

Results With Kineret

  • Swollen joint count: 0
  • Tender joint count: 0
  • ESR: 2
  • CRP: 6.20

This case represents one patient’s experience. Individual results may vary.

Date NOTES
  • 1994
    • Diagnosed with RA
    • Prescribed prednisone and hydroxychloroquine
    • Patient refused methotrexate
    • After 9 months, tapered off prednisone, continued hydroxychloroquine, and began nabumetone
    • Symptoms persisted
  • 2000
    • Began treatment with methotrexate
    • Symptoms persisted
  • 2001
    • Began treatment with initial biologic
    • Experienced intermittent pain and swelling
  • 2003
    • Hospitalized for group A strep infection in foot
    • Renal failure
    • Kidney biopsy showed poststreptococcal glomerulonephritis
    • Stopped treatment with biologic
    • Started hemodialysis
  • 2005
    • Renal transplant
    • Ended hemodialysis
    • Began treatment with Kineret
    • Symptoms improved (swollen and tender joints)
  • 2019
    • Continues Kineret treatment

A nurse’s story.

Peggy, a registered nurse living with difficult-to-treat RA, treats her symptoms with Kineret® (anakinra).

Peggy’s symptoms began at a busy time in her life.

“My symptoms started in 1993, the day before my daughter’s fifth birthday. I started to get really achy, almost flu-like. I got up in the morning with difficulty moving anything.... As time went on I continued to work, because if you’re not getting better, you just have to go with it. I wasn’t a complainer, but people could see that I was suffering.”— Peggy

For years, doctors were unable to find a treatment that worked for Peggy.

“I tried many different treatments to get my symptoms under control, but many of them didn’t work for me and I had a hard time tolerating them.... I started to worry. What if nothing could help me?”

But her rheumatologist was unwilling to give up.

“With multiple therapeutic failures, my rheumatologist continued her search for a treatment. She attended a rheumatology conference and with me and my RA diagnosis in mind, she came back and said ‘I have something for you.’ That’s when I started Kineret.”

Peggy experienced a reduction in her symptoms after starting Kineret.

“The fatigue and the aching in my joints started to improve.... My RA symptoms abated within 12 weeks, and didn’t return as long as I was compliant with the dosage and the maintenance schedule.”

This case represents one patient’s experience. Individual results may vary.