Adalimumab is given as a shot under the skin (subcutaneous
How It Works
Adalimumab reduces the effects of tumor
necrosis factor (TNF). TNF is produced in your body in times of
inflammation and attaches to the joint surface,
causing damage to soft tissues, cartilage, and bones. Adalimumab is a
disease-modifying antirheumatic drug (DMARD), which means it slows the
progression of conditions such as
rheumatoid arthritis and
ankylosing spondylitis. DMARDs are also called
immunosuppressive drugs or slow-acting antirheumatic drugs (SAARDs).
Why It Is Used
Adalimumab is used to treat adults who
have inflammatory conditions such as rheumatoid arthritis or ankylosing
spondylitis. Adalimumab may be used alone or in combination with other DMARDs
such as methotrexate.
How Well It Works
Adalimumab appears to work rapidly
and is well tolerated.
A clinical trial of adalimumab used in combination with methotrexate found a
20% improvement in 67% of people who were given the medicine, with improvements
noticeable after 1 week of treatment.1 In another
study of adalimumab used alone, researchers report significant, rapid,
sustained reductions in disease activity and improved physical function,
including reduced swelling and pain.2
Ankylosing spondylitis. Studies show that
adalimumab decreases disease activity and symptoms, and it increases quality of
The most common side effect of TNF
antagonists, such as adalimumab, is an allergic reaction to the injection
(shot). If you have a reaction to the shot, it will happen right away, either
during the shot or within 1 to 2 hours after the shot. Your doctor may give you
medicines to prevent or stop the reaction.
Symptoms of a reaction
to the shot include:
- Shortness of breath.
- Heat and
redness (flushing) in the
Warnings about serious side effects of TNF antagonists have
been issued. The U.S. Food and Drug Administration (FDA) and the drug’s
manufacturers have warned about:
- An increased risk of a serious infection. TNF antagonists affect
your body's ability to fight all infections. So if you get a fever, cold, or
the flu while you are taking this medicine, let your doctor know right
- An increased risk of blood or nervous system disorders. Call
your doctor if you have symptoms of blood disorders (such as bruising or
bleeding) or symptoms of nervous system problems (such as numbness, weakness,
tingling, or vision problems).
- A possible increased risk of
lymphoma (a type of blood cancer). It is not clear
whether this increase is because of the drug or because people with this
disease may already have a higher risk. There have been reports of a rare kind
of lymphoma, occurring mostly in children and teens taking TNF antagonists,
that often results in death.
- An increased risk of liver injuries.
Call your doctor if your skin starts to look yellow, if you are very tired, or
if you have a fever or dark brown urine.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Adalimumab is significantly more
expensive than DMARDs such as methotrexate and sulfasalazine.
Adalimumab should not be used by pregnant women or women of childbearing
age who are not using reliable birth control. If you are going to take
adalimumab, you should be on some form of reliable birth control. If you plan
to become pregnant, check with your doctor before stopping birth control and
trying to become pregnant.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Weinblatt ME, et al. (2003). Adalimumab, a fully human
anti-tumor necrosis factor-a monoclonal antibody alpha for the treatment of
rheumatoid arthritis in patients taking concomitant methotrexate.
Arthritis and Rheumatism, 48(1): 35-45.
Van de Putte LBA, et al. (2004). Efficacy and safety
of adalimumab as monotherapy in patients with rheumatoid arthritis for whom
previous disease modifying antirheumatic drug treatment has failed.
Annals of the Rheumatic Diseases, 63(5): 508-516.
Van er Heijde D, et al. (2006). Efficacy and safety of
adalimumab in patients with ankylosing spondylitis. Arthritis and Rheumatism, 54(7): 2136-2146.
Davis JC, et al. (2007). Health-related quality of
life outcomes in patients with active ankylosing spondylitis treated with
adalimumab: Results from a randomized controlled study. Arthritis and Rheumatism, 57(6): 1050-1057.