Understanding Arcalyst (Rilonacept)
Arcalyst, also known as rilonacept, is a prescription medication that acts as an interleukin-1 (IL-1) blocker. It is approved by the FDA for treating Recurrent Pericarditis (RP), Cryopyrin-Associated Periodic Syndromes (CAPS), and for maintaining remission in Deficiency of Interleukin-1 Receptor Antagonist (DIRA).
Important Safety Precautions Before Administration
Arcalyst can weaken the immune system, increasing the risk of serious infections.
- Do not start Arcalyst if you have an active or chronic infection.
- Report any signs of infection (fever, cough, flu-like symptoms) to your doctor immediately.
- Ensure vaccinations are current before starting treatment; avoid live vaccines during therapy.
- Tuberculosis screening is required before starting Arcalyst.
- Avoid taking Arcalyst with other IL-1 blockers or TNF inhibitors.
Step-by-Step Guide: How to Administer Arcalyst
Administering Arcalyst involves reconstitution of the powder followed by a subcutaneous injection. The initial injection should be supervised by a healthcare professional.
Phase 1: Reconstitution (Mixing the Medication)
Supplies Needed:
- Arcalyst powder vial
- Sterile Water for Injection (diluent)
- Two 3-mL syringes with 18-gauge needles (one for diluent, one for withdrawal)
- A 26-gauge, ½-inch injection needle
- Alcohol wipes
- Sharps disposal container
Instructions:
- Wash hands and prepare a clean surface.
- Check expiration dates. Arcalyst vials should be refrigerated and protected from light; allow to sit at room temperature briefly before use.
- Draw the required amount of sterile water with an 18-gauge needle.
- Inject sterile water into the Arcalyst vial, directing the stream along the side.
- Gently shake the vial side-to-side for about a minute, then let stand for a minute. Repeat if necessary until dissolved. Do not shake vigorously. The solution should be viscous, clear, and colorless to pale yellow.
- Inspect the solution for particles or discoloration before use. Use the mixed solution within 3 hours.
Phase 2: Subcutaneous Injection
- Draw the prescribed dose using a new 3-mL syringe and 18-gauge needle. The concentration is 80 mg/mL.
- Replace the 18-gauge needle with the 26-gauge injection needle.
- Select an injection site (abdomen, thigh, or upper arm) and clean with an alcohol wipe. Rotate sites for each dose.
- Pinch the skin, insert the needle at a 45-90 degree angle, and inject the medication slowly.
- Withdraw the needle and immediately place the used syringe and needle in a sharps container. Do not reuse needles or syringes.
Dosing Information
Arcalyst dosing varies based on the condition being treated and the individual patient. It is crucial to always follow the specific instructions provided by your doctor.
- Your doctor will determine the appropriate starting dose, which may be higher than subsequent doses.
- Maintenance doses are typically administered on a weekly basis.
- Dosing for pediatric patients may be based on weight.
Administration Options: At-Home vs. Healthcare Facility
Patients can administer Arcalyst at home after receiving proper training from a healthcare professional, or they can have the medication administered at a healthcare facility.
| Feature | At-Home Administration | Administration at Healthcare Facility |
|---|---|---|
| Convenience | High (flexible scheduling, no travel required) | Lower (requires appointments, travel to facility) |
| Cost | Potentially lower out-of-pocket expenses | May include additional facility fees |
| Technique | Requires patient training and confidence in self-administration | Performed by a trained healthcare professional |
| Monitoring | Relies on patient self-monitoring for side effects and response | Provides immediate professional observation and response |
| Supplies | Patient is responsible for managing and ordering supplies | Facility manages and provides necessary supplies |
Conclusion
Proper administration of Arcalyst is essential for achieving the intended therapeutic benefits and ensuring patient safety. Carefully follow the detailed steps for reconstitution and subcutaneous injection as instructed by your healthcare provider. Remember to rotate injection sites to minimize local reactions. It is important to be vigilant for any signs of potential infection, as Arcalyst can impact the immune system. Promptly communicate any concerns or side effects you experience to your healthcare provider. Adhering strictly to your doctor's prescribed dosage and the administration instructions is key to a safe and effective treatment experience. Patient support programs, such as Kiniksa OneConnect™, are available to provide assistance with financial aspects and educational resources related to Arcalyst.
For more information from the manufacturer, please visit the official ARCALYST® website.
