Canakinumab is a monoclonal antibody against IL-1β used to treat a variety of autoinflammatory diseases. Despite its remarkable efficacy, it may cause a variety of adverse reactions during treatment, which require close attention from patients and medical staff.
Side effects of canakinumab
Common side effects of different indications
For periodic fever syndromes (such as CAPS, TRAPS), the most common adverse reactions include diarrhea (incidence> 10%), flu-like symptoms and rhinitis. Patients with Still's disease are more likely to experience injection site reactions (such as redness, swelling, pain) and abdominal pain. Gout patients may develop nasopharyngitis, urinary tract infection or hypertriglyceridemia after use (incidence> 2%).
Risk of serious adverse reactions
Canakinumab may increase the risk of serious infections, including upper respiratory tract infections, tuberculosis reactivation and opportunistic infections (such as aspergillosis). About 1% of patients in clinical trials developed atypical infections, which required immediate discontinuation of the drug and targeted treatment.
After understanding the diversity of side effects, patients need to master the core precautions in treatment. The following content will detail the key management measures during medication.
Precautions for Canakinumab
Canakinumab works by suppressing the immune system. During treatment, infection prevention and control and immune management standards must be strictly followed to reduce health risks.
Management of infection risks
Tuberculosis screening (such as T-SPOT.TB or PPD test) must be completed before treatment, and patients with latent tuberculosis infection must first receive anti-tuberculosis treatment. Canakinumab is contraindicated during active infection. If fever, cough or weight loss occurs during treatment, you should immediately seek medical attention to identify the source of infection.
Immunization and allergic reactions
Pneumococcal vaccine and inactivated influenza vaccine must be administered according to the guidelines before medication, and live vaccines (such as measles and varicella vaccines) are prohibited. Canakinumab is contraindicated for those who are known to be allergic to it. If hypersensitivity reactions such as urticaria and dyspnea occur, the drug must be permanently discontinued and antihistamine treatment must be received.
After standardized management of infection and immune issues, regular medical examinations are the key to ensuring treatment safety. The following content will guide patients to conduct necessary medical monitoring.
What tests can be done when using canakinumab
Canakinumab treatment requires the combination of multiple laboratory and imaging tests to identify complications early and adjust the treatment plan.
Monitoring of routine infection and inflammatory indicators
Monthly blood routine tests (focus on neutrophil count), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patients with Still's disease need to monitor ferritin levels additionally. If ferritin is greater than 1000μg/L and accompanied by persistent fever, macrophage activation syndrome (MAS) should be alert.
Assessment of liver and kidney function and metabolism
Test liver enzymes (ALT, AST) and creatinine levels every 3 months. Gout patients need to test uric acid and triglycerides. Long-term users are recommended to undergo bone density testing every year to prevent the risk of osteoporosis.
During treatment, the drug must be strictly stored. Unopened canakinumab must be refrigerated at 2°C-8°C to avoid freezing. If the drug solution changes color or particles appear, it should be discarded immediately. If the patient has persistent diarrhea or repeated infections, he should contact the doctor in time to adjust the dose or suspend treatment. Through standardized medication and regular review, canakinumab can effectively control disease progression and improve patients' quality of life.
