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Adalimumab (Humira Injection): Uses, MOA, Side effects, Dosing

Adalimumab

humira adalimumab injection

Adalimumab (Humira) is a monoclonal anti-tumor necrosis factor alpha antibody that is used for the treatment of inflammatory conditions such as Ankylosing spondylitis, Crohn’s disease, and Rheumatoid arthritis.

Other TNF inhibitors include:

In this article, we will discuss the uses, mechanism of action, dosage, and side effects of Adalimumab.

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Uses of Adalimumab

Adalimumab is used to treat some forms of arthritis-related pain and swelling (such as rheumatoid, psoriatic, juvenile idiopathic, and ankylosing spondylitis).

Certain skin conditions are also treated with this drug (such as plaque-type psoriasis, and hidradenitis suppurativa).

It functions by inhibiting tumor necrosis factor (TNF), a protein produced by the immune system in the body that damages and swells joints in rheumatoid arthritis and creates red, scaly areas in psoriasis.

Adalimumab is a member of the TNF blocker drug subclass. This medicine aids in preventing future joint injury and maintaining joint function by lowering joint swelling.

A specific eye problem  (uveitis) and a few gastrointestinal disorders (Crohn’s disease, ulcerative colitis) are also treated with adalimumab.

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Mechanism of action of Adalimumab

Tumor necrosis factor-alpha (TNF-alpha) is specifically bound by adalimumab, which prevents it from interacting with the p55 and p75 cell surface TNF receptors.

In vitro, adalimumab also kills surface cells that express tumor necrosis factor when complement is present. Lymphotoxin is neither bound nor rendered inactive by adalimumab (Tumor necrosis factor-beta).

A naturally occurring cytokine called TNF participates in typical inflammatory and immunological reactions.

Patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis have higher levels of TNF in their joint synovial fluid, which is crucial for the pathologic inflammation and joint damage that are the primary side effects of these conditions. TNF levels have been found to be higher in psoriasis plaques as well.

Treatment with adalimumab for plaque psoriasis may reduce epidermal thickness and inflammatory cell infiltration.

It is unknown how these pharmacodynamics relate to the mechanism(s) through which adalimumab produces its therapeutic effects.

Adalimumab also modifies biological reactions brought by or controlled by TNF, such as alterations in the concentrations of adhesion molecules that control leukocyte movement during inflammation.

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Dosing information about Adalimumab

Adult Dose for Psoriatic Arthritis Every other week, 40 mg subcutaneously
Adult Dose for Crohn’s Disease – Acute Initial dosage: 160 mg subcutaneously on Day 1 (either all at once or divided over 2 days), then 80 mg subcutaneously two weeks later (Day 15)

Continuation dose: Start taking 40 mg subcutaneously every other week on Day 29 starting 2 weeks later.

Adult Dose for Ankylosing Spondylitis Every other week, 40 mg subcutaneously
Adult Dose for Rheumatoid Arthritis 40 mg subcutaneously every other week; for some RA patients not receiving concurrent methotrexate, increasing the frequency to 40 mg every week may be beneficial.
Adult Dose for Crohn’s Disease – Maintenance Initial dosage: 160 mg subcutaneously on Day 1 (either all at once or divided over 2 days), then 80 mg subcutaneously two weeks later (Day 15)

Continuation dose: Start taking 40 mg subcutaneously every other week on Day 29

Adult Dose for Ulcerative Colitis Initial dosage: 160 mg subcutaneously on Day 1 (either all at once or divided over 2 days), then 80 mg subcutaneously two weeks later (Day 15)

Continuation dose: Start taking 40 mg subcutaneously every other week on Day 29

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Side effects of Adalimumab

Most people don’t experience side effects, and those that do often don’t have anything major. However, you should speak with one of the medical staff members in charge of your treatment if you have very unpleasant side effects or are worried about your symptoms.

Common Side Effects

The most frequent adverse reactions include redness, swelling, or discomfort at the injection site. Changing your injection site frequently will help lower the likelihood of this.

Adalimumab can increase your risk of contracting infections since it interferes with your immune system. They may become more elusive as a result.

If you experience any infection-related symptoms, including a sore throat, fever, diarrhea, coughing up green phlegm, or any other new symptoms that worry you, call your doctor or the rheumatology nurse right away. Visit your doctor as soon as possible if any of these symptoms are severe. [ref]

Additionally, if you have chicken pox or shingles or come into touch with someone who has them, you should visit your doctor. If you use adalimumab, these diseases may worsen.

You could require antiviral therapy, and you might have to wait to resume taking the medication until you feel better.

Rare Side Effects

Skin cancer has been linked to various anti-TNF medications [ref]. However, there is no apparent connection between the two, and skin malignancies may typically be successfully treated when found early.

Wear sunscreen and often examine your skin for any new lesions or alterations to your freckles or moles to be safe.

Adalimumab may very infrequently result in a disease known as drug-induced lupus. A rash, fever, and worsening joint discomfort are symptoms. Any of these symptoms should be reported to your rheumatology team. Usually, after you stop taking adalimumab, it will go away.

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Written by Dr. Ahmed

Dr. Ahmed is an experienced Internist with over fifteen years of practice in the medical field. He strongly believes that true medical practice is about helping people, not just prescribing pills.
He has found that the best results come from motivating patients to make small lifestyle changes in addition to prescribing medications when necessary.
With a focus on managing obesity, diabetes, hypertension, asthma, depression, arthritis, migraine, high cholesterol levels, and many more medical conditions in his patients, he shares his knowledge and expertise through writing health-related articles for dibesity.com.
He is committed to helping patients achieve optimal health outcomes and improve their quality of life. For direct contact, he can be reached at contact@dibesity.com

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