Hypersensitivity reactions
Anakinra causes ADRs in 75% of patients. Many of them are related to
injection site reactions within the first weeks of application and can
present either as an IHR or NIHR
(144,145).
Systemic IHRs such as urticaria, angioedema, anaphylaxis (146-148), and
NIHRs (149) as infiltrating erythematous skin plaques were rarely
reported as single cases. IHR after a first dose of anakinra was
reported in a case possibly due to components that are able to induce a
direct mast cell degranulation (148,150).
For evaluating IHRs to anakinra, SPTs, and IDTs were performed with the
undiluted drug (147,148). Both for IHRs (146,148) and NIHRs (149),
successful desensitization protocols were reported.