Adalimumab (Humira®)

Adalimumab (Humira®) is a man-made fully human monoclonal antibody (a protein) that blocks TNF-a, a type of chemical messenger in the immune system that signals an inflammatory response in the body. In psoriasis, TNF-a over-stimulates immune system cells, called T cells, and causes psoriatic lesions to form.

Adalimumab is approved for use in adults with moderate-to-severe psoriasis when other treatments have been ineffective. More specifically, when other medicines cause side-effects or reactions that warrant discontinuation of therapy, alternative treatment options such as adalimumab can be explored. In some cases, adalimumab may be prescribed when an individual has other coexisting conditions along with psoriasis, which make certain treatments not suitable for use.

How the treatment works

• By limiting the activity of TNF-a, adalimumab is able to reduce the body's inflammatory reactions that lead to the development of psoriasis lesions
• Available as pre-filled syringes and pen devices
• Administered as a subcutaneous (just under the skin) injection in the stomach, thigh or upper arm
• If self-injecting, proper drug handling and storage is required
• The recommended dose for adults is 1 injection every 2 weeks, but some patients may need weekly administration.
• Must be used continuously to maintain improvement
• Also approved for psoriatic arthritis and other autoimmune disorders, such as rheumatoid arthritis, ankylosing spondylitis, and Crohn's disease.

Advantages/Benefits

• Patients may self-inject following proper training by a health care professional (usually a nurse)
• Generally well-tolerated, but long-term safety data is still being collected
• Adalimumab can prevent or limit further joint destruction as seen in psoriatic arthritis
• Adalimumab can be used in combination with methotrexate, a systemic medicine used to treat psoriasis and psoriatic arthritis, or NSAIDs that are prescribed for pain relief in arthritis.

Disadvantages/Risks

• Before starting therapy, you must be tested for any infection, including active and latent tuberculosis (TB).
• Common side-effects include injection site reactions (redness, swelling, itching, pain).
• Other common side effects include flu-like illness symptoms, headache, sinus infection, and hypertension (high blood pressure).
• Adalimumab can lower the ability of your immune system to fight opportunistic infections caused by bacteria, fungi or viruses.
• Other serious side effects include reactivation of TB or hepatitis B, severe allergic reaction, serious blood disorders, lymphoma, and skin and other cancers.
• Rare reports of serious side-effects include serious liver damage, demyelinating disorders (diseases involving the central nervous system), and worsening of cardiac failure.

Comments & Suggestions

• Continuous use is required to maintain improvements.
• In research studies, people taking adalimumab for psoriasis experienced improvement in skin symptoms after 16 weeks.
• You must be regularly monitored for infections during and for 5 months after treatment.