What is the difference between ILARIS and Kineret?

October 10, 2025 •

3 min read

Both ILARIS and Kineret are powerful biologic medications that target the inflammatory protein interleukin-1 (IL-1), but they have distinct mechanisms and clinical applications. While both can treat certain autoinflammatory conditions, understanding what is the difference between ILARIS and Kineret is critical for patients and healthcare providers. This comparison covers the crucial variances in their function, indications, and dosing frequency.

Quick Summary

ILARIS (canakinumab) is a monoclonal antibody that blocks IL-1β, while Kineret (anakinra) is a recombinant IL-1 receptor antagonist that blocks the IL-1 receptor, leading to different indications and dosing frequencies.

Key Points

Target Specificity: ILARIS targets the IL-1β cytokine directly, while Kineret blocks the IL-1 receptor, preventing both IL-1β and IL-1α from binding.
Dosing Frequency: ILARIS is given less frequently (e.g., every 4 to 8 weeks) due to its long half-life, while Kineret requires daily injections due to its short half-life.
Indication Differences: Kineret is FDA-approved for RA and specific CAPS variants like NOMID and DIRA. ILARIS has a broader range of autoinflammatory indications, including various CAPS types, Still's disease, and some gout flares.
Administration Route: Both medications are administered via subcutaneous injection, but Kineret is daily and ILARIS is less frequent.
Side Effect Profile: Kineret has a higher incidence of injection-site reactions due to its daily administration, while both carry a risk of serious infections.
Pharmacokinetics: The long half-life of ILARIS (approx. 26 days) contrasts sharply with Kineret's short half-life (approx. 6 hours), explaining their different dosing schedules.

Core Pharmacological Differences

ILARIS (canakinumab) and Kineret (anakinra) differ at a molecular level, impacting their clinical uses. This distinction is based on their targets in the interleukin-1 signaling pathway.

Ilaris: A Monoclonal Antibody Targeting IL-1β

ILARIS is a human monoclonal antibody that binds directly to the interleukin-1 beta (IL-1β) protein. By neutralizing IL-1β, ILARIS prevents it from interacting with receptors and starting inflammation. This targeted inhibition makes ILARIS effective for conditions driven by IL-1β.

Kineret: An Interleukin-1 Receptor Antagonist

Kineret is a recombinant form of the human interleukin-1 receptor antagonist (IL-1Ra). It works by competitively binding to the interleukin-1 type 1 receptor (IL-1R1), blocking both IL-1α and IL-1β and inhibiting IL-1's inflammatory effects.

Approved Indications

Although both drugs are used for cryopyrin-associated periodic syndromes (CAPS), their specific approved indications vary. {Link: American College of Rheumatology https://rheumatology.org/patients/canakinumab-ilaris} provides a detailed list of approved indications for both medications.

Dosing Frequency and Pharmacokinetics

The frequency of administration differs due to their pharmacokinetic properties.

Ilaris: Less Frequent Dosing

ILARIS has a half-life of about 26 days, allowing for less frequent administration, typically ranging from every 4 to 8 weeks depending on the condition.

Kineret: Daily Dosing

Kineret has a short half-life of typically 4 to 6 hours. It requires daily subcutaneous injection to maintain therapeutic levels. This daily dosing can be inconvenient and may increase injection-site reactions.

Comparison of ILARIS vs Kineret


Feature	ILARIS (canakinumab)	Kineret (anakinra)
Mechanism	Monoclonal antibody that neutralizes IL-1β.	Recombinant IL-1 receptor antagonist that blocks the IL-1 receptor.
Target	Specific IL-1β cytokine.	IL-1 receptor (blocks both IL-1α and IL-1β).
FDA-Approved Indications	Broader range of CAPS, Still's disease, FMF, specific gout flares.	RA, NOMID (a CAPS variant), DIRA, COVID-19 in specific settings.
Dosing Frequency	Less frequent, ranging from every 4 to 8 weeks depending on the condition.	Daily subcutaneous injections.
Half-life	Approximately 26 days.	Approximately 4 to 6 hours.
Common Side Effects	Cold/flu-like symptoms, injection-site reactions, gastrointestinal issues.	Injection-site reactions (very common), headache, nausea, cold symptoms.
Allergic Reactions	Less common, but can be severe. Manifestations include swelling and trouble breathing.	Reported, including anaphylaxis. Caution in latex-sensitive individuals as syringe cover may contain natural rubber.
Infection Risk	Both increase risk of serious infections. Patients tested for TB before starting.	Both increase risk of serious infections. Daily injection may cause higher risk of injection-site reactions.

Other Considerations

Combination Therapy

Kineret is not recommended with TNF blocking agents due to increased infection risk. Both medications interact with other immunosuppressants, requiring careful review by a healthcare provider.

Pediatric Use

ILARIS is approved for certain CAPS and Still's disease in pediatric patients 2 years and older. Kineret is approved for NOMID and DIRA in children. Dosing for children is typically weight-based.

Conclusion

ILARIS and Kineret are both IL-1 inhibitors for inflammatory conditions, but they are not interchangeable. ILARIS is a long-acting monoclonal antibody targeting IL-1β, allowing for less frequent dosing and used for various autoinflammatory syndromes. Kineret, with its short half-life and receptor-blocking action, requires daily administration and treats conditions like RA and NOMID. The choice depends on the specific disease, patient age, dosing convenience, and side effect profile. {Link: American College of Rheumatology https://rheumatology.org/patients/canakinumab-ilaris} offers more detailed information on their uses and differences. For detailed Kineret information, refer to the FDA Kineret Prescribing Information.

Frequently Asked Questions

No, while both treat some overlapping autoinflammatory syndromes (CAPS), they have distinct approved indications. For example, Kineret is approved for rheumatoid arthritis (RA), whereas ILARIS is approved for Still's disease and specific types of CAPS.

Kineret is administered more frequently, typically via a daily subcutaneous injection. ILARIS has a longer half-life, allowing for less frequent injections, such as every 4 to 8 weeks.

The main difference is their molecular target. ILARIS (canakinumab) is a monoclonal antibody that binds to and neutralizes the IL-1β protein. Kineret (anakinra) is a receptor antagonist that blocks the IL-1 receptor on cells, preventing IL-1 from initiating an inflammatory response.

They share some side effects, such as increased risk of infection. However, due to its daily administration, Kineret is associated with a much higher rate of injection-site reactions. Both medications carry a risk of serious infections and other immune-related side effects.

No, combining ILARIS or Kineret with other IL-1 blockers or with TNF blocking agents is not recommended and can increase the risk of serious infections.

The choice depends on several factors, including the specific diagnosis, the patient's age, and the desired dosing frequency. For instance, Kineret is indicated for RA, while ILARIS is not. A specific condition will often dictate which medication is most appropriate.

Efficacy depends on the specific condition being treated. For instance, in a study of VEXAS syndrome, canakinumab (ILARIS) was found to be more effective than anakinra (Kineret). However, this is not the case for all conditions. Efficacy is condition-specific, and a healthcare provider should make the determination based on the patient's needs and the latest clinical evidence.