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Adalimumab

Medical and Pharmacy Editor:

Brand Name: Humira, Amjevita, adalimumab-atto

Generic Name: Adalimumab

Drug Class: Monoclonal Antibodies; DMARDs, TNF Inhibitors; Antipsoriatics, Systemic; Inflammatory Bowel Disease Agents

What Is Adalimumab and How Does It Work?

Adalimumab is used to reduce pain and swelling due to certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, ankylosing spondylitis). Adalimumab is also used to treat certain skin disorders (such as plaque-type psoriasis, hidradenitis suppurativa). It works by blocking a protein (tumor necrosis factor or TNF) found in the body's immune system that causes joint swelling and damage in arthritis as well as red scaly patches in psoriasis. Adalimumab belongs to a class of drugs known as TNF blockers. By reducing joint swelling, this medication helps to reduce further joint damage and preserve joint function.

Adalimumab is also used to treat certain bowel conditions (Crohn's disease, ulcerative colitis) and a certain eye disease (uveitis).

Adalimumab is available under the following different brand names: Humira, Amjevita, and adalimumab-atto.

Dosages of Adalimumab:

Adult and Pediatric Dosage Forms and Strengths

Prefilled syringe/pen

  • 20mg/0.4mL (Humira, Amjevita) (pediatric)
  • 40mg/0.8mL (Humira, Amjevita)

Biosimilars to Humira

  • Amjevita (adalimumab-atto)

Dosage Considerations – Should be Given as Follows:

Rheumatoid Arthritis

Humira, Amjevita

  • Indicated for reduction of signs and symptoms, induction of major clinical response, inhibition of progression of structural damage, and improvement of physical function in adults with moderate-to-severe active rheumatoid arthritis 40 mg subcutaneously (SC) every 2 weeks
  • Dosing considerations
    • May be administered as monotherapy or combined with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs)
    • If not taken with concomitant methotrexate, additional benefit may be derived from increasing adalimuamb dosing frequency to once weekly

Psoriatic Arthritis

Humira, Amjevita

  • Indicated for reduction of signs and symptoms, inhibition of progression of structural damage, and improvement of physical function in adults with active psoriatic arthritis
  • 40 mg subcutaneously (SC) every 2 weeks
  • Dosing considerations
    • May be administered as monotherapy or combined with methotrexate or other nonbiologic DMARDs
    • If not taken with concomitant methotrexate, additional benefit may be derived from increasing adalimumab dosing frequency to once weekly

Juvenile Idiopathic Arthritis

Humira, Amjevita

  • Indicated for reduction of signs and symptoms of moderately-to-severely active polyarticular juvenile idiopathic arthritis
  • May be administered with methotrexate, glucocorticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), or analgesics
  • Humira
    • Children under 2 years or less than 10 kg: Safety and efficacy not established
    • Children 2 years and older
      • 10 kg to less than 15 kg: 10 mg subcutaneously (SC) every 2 weeks
      • 15 kg to less than 30 kg: 20 mg SC every 2 weeks
      • 30 kg and greater: 40 mg SC every 2 weeks
  • Amjevita
    • Children under 4 years: Safety and efficacy not established
    • Children 4 years and older:
      • 15 kg to less than 30 kg: 20 mg subcutaneously (SC) every 2 weeks
      • 30 kg and greater: 40 mg SC every 2 weeks

Ankylosing Spondylitis

  • Humira, Amjevita
  • Indicated for reduction of signs and symptoms of active ankylosing spondylitis
  • 40 mg subcutaneously (SC) every 2 weeks
  • Dosing considerations
    • May be administered as monotherapy or combined with methotrexate or other nonbiologic DMARDs
    • If not taken with concomitant methotrexate, additional benefit may be derived from increasing adalimumab dosing frequency to once weekly

Plaque Psoriasis

Humira, Amjevita

  • Indicated for treatment of moderate-to-severe chronic plaque psoriasis in patients who are candidates for systemic therapy or phototherapy and for whom other systemic therapies are inappropriate
  • 80 mg subcutaneously (SC) once, then, after 1 week, 40 mg SC every 2 weeks
  • Humira prescribing information includes patients with moderate-to-severe fingernail psoriasis

Crohn's Disease

  • Humira, Amjevita
  • Indicated for reduction of signs and symptoms and induction and maintenance of clinical remission in adults with moderately to severely active Crohn's disease who have had inadequate response to conventional therapy; may be used in patients who have lost response to or are intolerant of infliximab
  • Induction: 160 mg subcutaneously (SC) either as 4 injections of 40 mg on day 1 or as 2 injections of 40 mg daily on 2 consecutive days, then 80 mg SC 2 weeks later (day 15)
  • Maintenance (beginning Week 4 [Day 29]): 40 mg SC every 2 weeks
  • Dosing considerations

Pediatric Crohn's Disease

Humira

  • Indicated to reduce signs and symptoms, and achieve and maintain clinical remission in pediatric patients with moderately to severely active Crohn's disease who have had an inadequate response to corticosteroids or immunomodulators (e.g., azathioprine, 6-mercaptopurine, methotrexate)
  • Children under 6 years: Safety and efficacy not established
  • Children 6 years and older (17 kg to less than 40 kg)
    • Induction: 80 mg subcutaneously (SC) on Day 1 (administer as two 40 mg injections in one day); THEN 2 weeks later (Day 15) give 40 mg
    • Maintenance (beginning Week 4 [Day 29]): 20 mg SC every 2 weeks
  • Children 6 years and older (greater than 40 kg)
    • Induction: 160 mg SC on Day 1 (administer as four 40 mg injections in one day or as two 40 mg injection per day for two consecutive days); THEN 2 weeks later (Day 15) give 80 mg (as two 40 mg injections in one day)
    • Maintenance (beginning Week 4 [Day 29]): 40 mg SC every 2 weeks

Ulcerative Colitis

Humira, Amjevita

  • Indicated for treatment of ulcerative colitis unresponsive to immunosuppressants (e.g., corticosteroids, azathioprine, 6-mercaptopurine [6-MP])
  • Induction: 160 mg subcutaneously (SC) either as 4 injections of 40 mg on day 1 or as 2 injections of 40 mg daily on 2 consecutive days, then 80 mg SC 2 weeks later (day 15)
  • Maintenance (beginning Week 4 [Day 29]): 40 mg SC every 2 weeks
  • Continue maintenance dose only if evidence of clinical remission is apparent by 8 weeks of therapy

Hidradenitis Suppurativa

Humira

  • Indicated for treatment of moderate-to-severe hidradenitis suppurativa (Hurley stage 2 and Hurley stage 3 disease)
  • Induction: 160 mg subcutaneously (SC) either as 4 injections of 40 mg on day 1 or as 2 injections of 40 mg daily on 2 consecutive days, then 80 mg SC 2 weeks later (day 15)
  • Maintenance (beginning Week 4 [Day 29]): 40 mg SC once/week

Uveitis

Humira

  • Indicated for treatment of noninfectious intermediate, posterior, and panuveitis in adults
  • 80 mg subcutaneously (SC) once, then, after 1 week, 40 mg SC every 2 weeks
Medically Reviewed by a Doctor on 8/10/2017



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