Adalimumab in the Treatment of Rheumatoid Arthritis

Abstract

Adalimumab (Humira® , Abbott Laboratories, IL, USA) is a biological, disease-modifying antirheumatic drug for the treatment of rheumatoid arthritis, psoriatic arthritis and potentially other inflammatory rheumatic disorders and autoimmune diseases. Adalimumab is a fully human immunoglobin G1 monoclonal antibody that binds specifically to tumor necrosis factor, thereby neutralizing the activity of this central cytokine in the rheumatoid arthritis disease process. Adalimumab’s efficacy and activity in the suppression of rheumatoid arthritis, both in combination with methotrexate or other disease-modifying antirheumatic drugs, and as monotherapy, is well established. It has been shown to be effective both in long-standing, moderate-to-severe rheumatoid arthritis and in early disease. In randomized controlled trials and open-label studies, clinical response from adalimumab was rapid (1–2 weeks) and has been sustained through 6 years. Adalimumab also improves quality of life and inhibits structural damage. The clinical remission rate of adalimumab plus methotrexate in early rheumatoid arthritis is nearly 50%. Adalimumab is generally well tolerated. In rheumatoid arthritis clinical trials, there were more injection site reactions with adalimumab compared with placebo. Cases of tuberculosis and opportunistic infections have been reported, and adequate screening and monitoring before and during therapy are recommended. Lymphoma incidence is probably identical to that observed in patients with severe rheumatoid arthritis. Induction of clinically significant autoimmune diseases is rare.