Table 4.
Adverse events reported in association with interleukin-1 receptor blockers
| Adverse event categories | Examples of adverse events reported during use of interleukin-1 receptor blockers | ||
|---|---|---|---|
| Anakinra 90,94,95 | Rilonacept 97 | Cannakinumab 97,99,101 | |
| Musculoskeletal | Arthritis flare, arthralgia, limb pain, osteonecrosis of the femoral head, vertebral collapse, MAS | Arthritis flare, MAS | Arthritis flare, MAS, leg fracture |
| Haematological | Transient neutropenia, anaemia | Pancytopenia, anaemia | Leucopenia, thrombocytopenia, prolonged activated partial thromboplastin time |
| Gastrointestinal | Diarrhoea, nausea, abdominal pain, vomiting, elevated alanine aminotransferase, new-onset CD | – | Abdominal pain, vomiting, pneumonia, aminotransferase elevations |
| Cardiorespiratory | Cough, sore throat | Pulmonary fibrosis | Cough |
| Infectious | Hepatitis due to CMV, URTI, visceral Leishmania infection, varicella, rhinopharayngitis, labial herpes, uncomplicated hepatitis A | URTI, gastroenteritis, nasopharyngitis, skin infection, ear infection, influenza | Nasopharyngitis, URTI, varicella, otitis media, urosepsis, measles, pneumonia, Epstein–Barr virus |
| Immunological and/or autoimmune | Local injection-site reactions (ecchymosis, erythema, inflammation, pain, pruritis), anti-IL-1 receptor antibody development | Local injection-site reactions (erythema, bruising), development of anti-rilonacept antibodies | Non-neutralizing anti-canakinumab antibody development |
| Ophthalmological | – | – | Uveitis |
| Neurological | Headache | – | Headache, syncope |
| Renal and/or urological | Dysuria, nephrosis | – | – |
| Malignancy | None reported | None reported | None reported |
| Psychiatric | – | Depression | – |
| Dermatological | Rash | – | Rash |
| Other | Fever, whole-body pain | Fever | Fever, arm pain, lymphadenopathy, splenic cyst, haematoma, two deaths* |
Abbreviations are as follows: CD, Crohn's disease; CMV, cytomegalovirus; IL-1, interleukin-1; MAS, macrophage activation syndrome; URTI, upper respiratory tract infection.
*
One patient had urosepsis and MAS whilst on placebo (following eight doses of canakinumab); the second patient died of MAS and severe pulmonary hypertension whilst on canakinumab.