Resource

Adalimumab

Adalimumab is a ‘biologic’ drug. Biologic drugs are often referred to as ‘targeted therapies’ because they work on specific cells of the immune system. Adalimumab works on the TNFα cells.

Print

Other names

Humira (originator); Amgevita, Hulio, Hyrimoz, Imraldi (biosimilars)

Type of JIA

ALL (Note: Adalimumab is not generally given in systemic onset JIA, but can be effective for some children with that type of JIA)

How is it taken?

Injection

How often?

Every two weeks

How long for?

Long term

How soon does it start working?

From two to 12 weeks

Background

Adalimumab was made available for rheumatoid arthritis in 2003 and subsequently for JIA from 2008. It has been commissioned by the NHS since 2014.

Usage

Adalimumab can be prescribed alone if necessary but is often added to methotrexate and this combination is also prescribed for uveitis.

Adalimumab is given as an injection every two weeks. Adalimumab may be prescribed together with methotrexate; the drugs combined assist better control of symptoms and help to prevent the body developing antibodies to the adalimumab. Adalimumab may be used on its own if the child or young person is no longer able to cope with the side effects of methotrexate.

Precautions

DO NOT ADMINISTER abatacept, adalimumab, canakinumab, etanercept or tocilizumab to a child or young person if they have a high temperature of 38°C or above or you are concerned that they are unwell with an infection (don’t worry if they just have a minor cough or cold) – seek medical advice from your GP or child’s healthcare team.

Blood tests

Are performed to make sure there are no problems with cell counts. This is the same as for sDMARDs but

the tests are performed much less often (typically every six months). Your child’s healthcare team will talk to you about this and any other test they need to arrange.

Vaccinations

‘Live’ vaccines – measles, mumps, rubella (MMR), chickenpox, oral polio (NOT injectable polio), BCG, oral typhoid and yellow fever – cannot be given to anyone already taking a biologic DMARD. If biologic treatment has not yet been started, it is important to seek advice on how long a gap to leave after having a live vaccine.

Other medicines

There are currently no specific prescribed medicines to be avoided when taking bDMARDs. But take care when using any other medications or complementary therapies (even if bought ‘over the counter’ for coughs, colds or flu). Check with a doctor, nurse or pharmacist that they are safe.

Alcohol

Alcohol can be consumed when taking bDMARDs such as abatacept, adalimumab, canakinumab, etanercept and tocilizumab. However, caution may be required when taking other medications – methotrexate, for example – alongside biologics.

Pregnancy

There is not enough research information to give advice that either pregnancy or breastfeeding are safe while taking bDMARDs, and reliable contraception should be considered if sexually active.

Tattoos and body piercings

When taking a bDMARD, there may be an increased risk of skin infection associated with the tattooing. It is therefore important to consider this and where the tattoo is being performed. If the skin becomes particularly red more than 24 hours afterwards and/or a fever is developed, you may need antibiotics.

Updated: 01/07/2021