Adalimumab (Humira)

A TNF-inhibiting, anti-inflammatory, biologic medication.

It binds to tumor necrosis factor-alpha (TNFα), which normally binds to TNFα receptors, leading to the inflammatory response of autoimmune diseases.

By binding to TNFα, it reduces this inflammatory response.

Because TNFα is also part of the immune system, which protects the body from infection, treatment with adalimumab may increase the risk of infections.

Latent infections such as tuberculosis can be reactivated, and the immune system may be unable to fight new infections.

Fatal infections have occurred in some patients.

It is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, chronic psoriasis, hidradenitis suppurativa, and juvenile idiopathic arthritis. It has also been approved to treat the rare chronic eye condition birdshot retinochoroidopathy.

In rheumatoid arthritis, adalimumab has a response rate similar to methotrexate, and in combination, it nearly doubles the response rate of methotrexate alone.

Pregnancy category AU: C

Routes of administration-Subcutaneous

Bioavailability 64% subcutaneously.

Elimination half-life 10–20 days.

It is an immunosuppresive medication, used to treat autoimmune diseases such as rheumatoid arthritis.

Administered by subcutaneous injection.

The maintenance treatment is an injection every other week.

Reduce the signs and symptoms of moderate to severe rheumatoid arthritis (RA) in adults.

It may be used alone or in combination with DMARDs.

Has efficacy in moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 4 and older, and is approved for the treatment of that condition.

In RA approved for use alone, or with methotrexate or similar medicines, in the U.S.

Reduces the signs and symptoms of, and is approved for treatment of, ankylosing spondylitis in adults.

Reduces the signs and symptoms of moderate to severe Crohn’s disease.

Approved for treatment of moderate to severe cases of ulcerative colitis in adults, and hidradenitis suppurativa.

Effective therapy when used either continuously or intermittently in patients with moderate to severe psoriasis.

Reduces the signs and symptoms of moderate to severe polyarticular juvenile idiopathic arthritis in children 4 and older.

Adverse efffects: serious and sometimes fatal blood disorders; serious infections, including tuberculosis, and infections caused by viruses, fungi, or bacteria; rare reports of lymphoma and solid tissue cancers; rare reports of serious liver injury; rare reports of demyelinating central nervous system disorders; and rare reports of cardiac failure.

The third TNF inhibitor, after infliximab and etanercept, to be approved in the United States.

Constructed from a fully human monoclonal antibody, while infliximab is a mouse-human chimeric antibody and etanercept is a TNF receptor-IgG fusion protein.

There are a number of biosimilar agents available.


Half-life 2 weeks and administered subcutaneously every 2 weeks.

30% response rate in Crohn’s disease.

This agent superior to methotrexate 16 weeks after initiating treatment for psoriasis (Saurat J-H).

Development of antidrug antibodies associated with lower drug concentration and lower likelihood of minimal disease activity or clinical remission (Bartels GM et al).

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