What is Adalimumab?Under the trade name Humira® Adalimumab is used in inflammatory rheumatic diseases.
Adalimumab is a human monoclonal antibody that specifically binds to TNF-alpha and belongs to the group of so-called TNF-blockers. By binding to TNF-alpha, it prevents the function of the messenger. Adalimumab belongs to the so-called biologics.
These include drugs that are produced by biotechnological methods. Adalimumab is produced in CHO cells, a Chinese hamster ovary cell line. Nevertheless, adalimumab, unlike other antibodies used as drugs, consists exclusively of human components.
TNF-alpha is involved in the body as a messenger of the immune system in inflammatory reactions. In inflammatory rheumatic diseases, it is in the synovial fluid in increased concentration and is crucially involved in the development of inflammatory processes.
Blocking TNF-alpha with adalimumab can reduce inflammation and other symptoms in these conditions. Adalimumab binds to TNF-alpha, so that this can not perform its function as a messenger. Inflammatory parameters such as the C-reactive protein and interleukin-6 are decreasing. Likewise, levels of specific enzymes involved in cartilage destruction in inflammatory rheumatic diseases are decreasing.
Pain and swelling improve. Adalimumab works fast and inhibits the progression of the disease. However, since TNF-alpha plays an important role in the immune system of the body, adalimumab also inhibits desirable processes of the messenger in the human body. Thus, the immune system is weakened, which leads to an increased risk of infection. There is a possibility of an increased probability of tumorigenesis such as the formation of malignant lymphomas. Adalimumab has a half-life of 14 to 19 days in the body. This means that only half of the drug can be detected in the blood after this period of time.
Medical application & use
Adalimumab can be used in patients with a variety of inflammatory rheumatic diseases where other therapy has not been successful or no other therapy can be given. These include moderate to severe active rheumatoid arthritis, active and progressive psoriatic arthritis, axial spondyloarthritis, moderate to severe Crohn's disease, and ulcerative colitis, as well as psoriasis in adult patients.
For children, adalimumab may be used in severe active Crohn's disease, active polyarticular juvenile idiopathic arthritis, and active enthesitis-associated arthritis. In any case, prescription by a doctor and medical supervision during treatment is required. Adalimumab is available as an injection solution. It is given as pre-filled syringe or pre-filled pen. For children, it is also available in a vial.
Adults usually receive a dose of 40 mg of adalimumab every two weeks, which is injected under the skin. After instruction by the doctor, patients can do this themselves. Depending on the clinical picture, a higher starting dose may be required. For children up to 4 years, the maximum dose is 20 mg every two weeks and is calculated according to height and weight. The effect of Adalimumab occurs very fast and sometimes already on the first day.
Most patients feel relief from symptoms after two to three weeks. However, the maximum effect of the drug is often reached after two to three months. If the doctor and the patient decide to take adalimumab, it must be long-term, otherwise the symptoms get worse again.
Risks & Side Effects
Adalimumab's most common side effects are respiratory infections, low levels of white or red blood cells, high blood levels of fat, headache, abdominal pain, nausea and vomiting, skin rash, joint and muscle pain, reactions such as redness at the site of injection and elevated levels of liver enzymes.
Adalimumab should not be used in patients with active tuberculosis, severe infections or heart failure. In addition, certain vaccinations should not be given while on adalimumab. Since adalimumab can reactivate tuberculosis, the attending physician examines patients for signs and symptoms of tuberculosis before starting treatment.