Can a Patient with CAPS Take Arcalyst and Alcohol?
There is no specific contraindication to consuming alcohol while taking Arcalyst (rilonacept) for CAPS, but patients should limit alcohol intake to well below national guidelines and discuss consumption with their healthcare provider, particularly given the chronic inflammatory nature of CAPS and potential for organ involvement.
Key Considerations for Alcohol Use with Arcalyst
No Direct Drug-Alcohol Interaction Documented
- Arcalyst (rilonacept) is an IL-1 blocker approved for treatment of CAPS, specifically familial cold autoinflammatory syndrome (FCAS) and Muckle-Wells syndrome (MWS) in patients 12 years and older 1, 2.
- The available literature on rilonacept does not identify alcohol as a contraindication or document specific drug-alcohol interactions 1, 3, 2, 4.
- Unlike medications such as methotrexate where alcohol significantly increases hepatotoxicity risk, rilonacept's mechanism of action (IL-1β blockade) does not inherently interact with alcohol metabolism 5.
Disease-Specific Alcohol Considerations in CAPS
Patients with CAPS should exercise caution with alcohol due to the chronic inflammatory nature of their condition and risk of complications:
- CAPS patients face serious complications including secondary amyloidosis (occurring in 25% of MWS patients), which can cause renal failure and requires kidney transplantation in severe cases 1, 6.
- Alcohol consumption is associated with increased inflammatory markers and can exacerbate chronic inflammatory conditions 5.
- In other rheumatic and musculoskeletal diseases, moderate alcohol consumption has been associated with increased disease activity and flare risk 5.
General Alcohol Guidance for Chronic Inflammatory Conditions
The approach to alcohol in CAPS should mirror recommendations for other chronic inflammatory diseases:
- Alcohol consumption should be discussed with healthcare professionals, particularly when starting new treatments like Arcalyst 5.
- Low levels of alcohol consumption are generally unlikely to negatively impact disease outcomes in most rheumatic conditions, though this has not been specifically studied in CAPS 5.
- Patients should be aware that alcohol can increase risk of comorbidities and potentially worsen inflammatory disease activity 5.
Practical Recommendations
For CAPS patients on Arcalyst who choose to consume alcohol:
- Limit intake to well below national guidelines (similar to recommendations for patients with other chronic conditions requiring immunomodulatory therapy) 5.
- Avoid alcohol entirely if there is evidence of organ involvement, particularly liver or kidney disease 5.
- Given that CAPS can lead to amyloidosis with renal complications, patients with any degree of renal impairment should be especially cautious 6.
- Discuss alcohol consumption patterns openly with the treating physician to allow for individualized risk assessment based on disease severity and organ involvement 5.
Monitoring Considerations
- Patients on Arcalyst require monitoring for treatment response and adverse events, with the primary adverse events being injection-site reactions and upper respiratory tract infections 2.
- If consuming alcohol, patients should be particularly vigilant about infection risk, as both alcohol and immunomodulatory therapy can affect immune function 2.
- Regular monitoring of inflammatory markers (high-sensitivity CRP and serum amyloid A) remains important regardless of alcohol consumption 3, 2.