For certain people who have moderate or severe inflammatory bowel diseases (IBD), such as Crohn’s disease (CD) or ulcerative colitis, adalimumab is a biologic treatment that may help to reduce their symptoms.1,2 It is sold in the United States under the name Humira.
Adalimumab is usually recommended for people with IBD who have not responded well enough to other types of medication—such as aminosalicylates (5-ASAs), antibiotics, corticosteroids, and immunosuppressants. It is also an option for people for whom infliximab, another type of biologic therapy, either does not work or has stopped working for them.
How does adalimumab work?
As a type of biologic medicine called an anti-tumor necrosis factor (anti-TNF), adalimumab contains special kinds of proteins made in a laboratory called antibodies.1,2 These special antibodies work by finding and blocking the effect of other proteins in the body, called “tumor necrosis factor alpha,” that are made by the immune system to respond to infections and other problems by triggering inflammation.
People with inflammatory bowel diseases may have immune systems that make too much of this protein, which can cause excessive and unnecessary inflammation in their digestive tracts. This inflammation can cause the signs and symptoms of IBD. By blocking the proteins that trigger this inflammation, adalimumab can benefit some people with moderate-to-severe IBD by:
- Relieving the symptoms of IBD
- Helping them to enter remission more quickly
- Helping them to stay in remission for a longer time1,2
Who can take adalimumab?
Adalimumab is approved in the United States for treating people with moderate or severe CD who are over 6 years of age and who have not responded well enough to corticosteroids or immunomodulators.3 It can also be prescribed for children over the age of 5 and adults who have moderate-to-severe ulcerative colitis whose disease has not responded adequately to corticosteroids or immunomodulators.3 Limitations of Use: Effectiveness has not been established in patients who
have lost response to or were intolerant to TNF blockers.
Before prescribing adalimumab, healthcare providers need to know about any medicines or supplements that the patient is taking. Women who are pregnant, planning to become pregnant, or breastfeeding should also inform their healthcare providers. People who are taking adalimumab should not receive any kind of live vaccines during treatment, and before treatment, they need to make sure that all of their vaccinations are up to date. Patients will be tested for TB before starting treatment.3
Because of some of the side effects linked to adalimumab, healthcare providers need to know if the patient currently has any type of infection, tends to get infections often, or has recurring infections. They also need to know if the patient has, or has ever had:3
- Tuberculosis, or has been near someone with tuberculosis
- Immune system problems
- Any type of cancer
- An allergic reaction to rubber or latex
- Heart failure or other heart condition
- Hepatitis B
- Nervous system conditions, such as multiple sclerosis or Guillain-Barre syndrome
What side effects are linked to adalimumab?
The most common side effects experienced by people who take adalimumab are:3
- Upper respiratory or sinus infections
- Reactions around the injection site, such as redness, rash, swelling, itching, or bruising
Adalimumab changes the way the body’s immune system works, which can make people more likely to get infections and make it more difficult to fight them off. These can include serious viral, bacterial, or fungal infections, including tuberculosis (patients are tested for tuberculosis before beginning treatment with adalimumab).3
Healthcare providers carefully monitor patients taking adalimumab for any signs of infection or other serious side effects, including:3
- Heart failure
- Hepatitis B
- Liver injury
- Blood problems
- Nervous system problems
- Skin cancer
To note: malignancies/lymphoma are a black box warning. These are not all the possible side effects of adalimumab. Patients should talk to their doctor about what to expect with treatment with adalimumab.