What is adalimumab and why is it prescribed?
Adalimumab (trade name: Humira) is an anti-TNF drug. In rheumatoid arthritis and some other conditions, too much of a protein called TNF (tumour necrosis factor) is produced in the body, causing inflammation, pain and damage to the bones and joints. Anti-TNF drugs such as adlimumab block the action of TNF and so reduce this inflammation.
Adalimumab isn't a painkiller but can modify the disease and improve your symptoms over a period of 2–12 weeks.
Adalimumab can be prescribed by a rheumatologist for:
There are national and local guidelines that determine when it can be used, and these vary according to which condition you have. It's often prescribed along with a disease-modifying drug such as methotrexate.
Is there any reason I won't be prescribed adalimumab?
Adalimumab won't be started if:
- the disease isn't active
- you have an infection
- you haven't tried other treatments appropriate for your condition first.
Doctors sometimes use a score known as DAS28 to work out how active your arthritis is. This counts how many of 28 specific joints are tender and swollen, and looks at inflammation levels in a blood test. You'll also be asked to score how well you feel on a scale of 0 to 10.
Your doctor may decide not to prescribe adalimumab if you've had:
- repeated or severe infections
- multiple sclerosis (MS)
- a serious heart condition
- lung fibrosis (scarring of the lung tissue).
Before starting adalimumab you'll have a chest x-ray and tests to check if you've ever been exposed to tuberculosis (TB). You may need treatment for latent (asymptomatic) TB before starting adalimumab. You'll also be checked for previous hepatitis infection, as adalimumab may increase the risk of this being reactivated.
You may have further blood tests while you're on adalimumab to monitor its effects.