What is adalimumab?
Adalimumab, sold under the brand name "Humira", is an anti-inflammatory selected from the group of tumor necrosis factor blockers, more in particular, TNF-alpha inhibitors. It is a monoclonal antibody made up of 1330 amino acids.
TNF-alpha is a body-own inflammatory protein, which is usually involved in chronic inflammations of the gastro-intestinal tract and the joints. By blocking these TNF-alpha, the inflammation of the diseased part of the body is inhibited, and again healthy tissue can be created because the proteins are being blocked that are involved in inflammation, adalimumab, thus providing a less vigilant immune system. Because of this, the patient must always be alert to the first signs of infection or disease.
Adalimumab can through its influence on the immune latent infections such as tuberculosis activate. Before adalimumab is started will therefore always a tuberculin skin test and a chest X-ray performed. Only if this test is negative can definitely be there to start adalimumab. Patients with heart disease are examined thoroughly before treatment is started.
Adalimumab is made from 100% human components, in contrast to infliximab (Remicade), which consists mainly of mouse and rat proteins. As a result, the risk of allergic reactions decreases significantly compared to the use of infliximab.
Applications
Adalimumab is used in the treatment of Crohn's disease, rheumatoid arthritis, Bechterew's disease, ulcerative colitis, and sometimes also for psoriasis.
The treatment for Crohn's disease is done in three steps, by subcutaneous injections. The injection takes place in a fold of skin, alternately in the arm, abdomen and thighs. If one would inject always at the same place, there occurs quickly on skin inflammation. The prick of the injection itself is not painful, but when injecting the drug may be a stinging sensation will occur under the skin. The injection of adalimumab should be done slowly, over some 30-odd seconds. The start-up schedule is as follows:
-Week 1: 160 mg Adalimumab
-Week 3: 80 mg adalimumab
-Week 5: 40 mg adalimumab
Then there are two weekly 40 mg adalimumab administered as maintenance treatment.
Very common side effects are mostly mild redness and inflammation at the place of injection. Frequent inflammation of the airways, such as pneumonia and bronchitis. Less common skin disorders, abdominal pain, disorders of the nervous system (such as tremor) and for hair loss.
Adalimumab appears in one out of three patients to elicit antibody production by which the agent has greatly reduced activity.
Storage and packaging
Adalimumab should always be stored in a cool place (the ideal temperature is between 2 and 8 degrees C). Each pack consists Adalimumab injection pre-filled syringes of twe or pens of 40 mg / 0.8 ml and two ontstmettingsdoekjes, for disinfecting the injection site.