Rheumatoid arthritis adalimumab

Adalimumab Anti-TNFa Rheumatoid arthritis, anklyosing spondylitis... 

Adalimumab (Humira ) is a folly human anti-TNF monoclonal antibody that is mainly used in combination with methotrexate to treat rheumatoid arthritis in adults [3]. Meanwhile, it is also used against arthritis of psoriasis and ankylosing spondylitis. Its therapeutic value in Crohn s disease is under clinical trial. 

Adalimumab is a TNF-a inhibitor initially approved for the treatment of rheumatoid arthritis in 2003. It is approved for treatment of psoriatic arthritis and off-label uses and clinical... 

Humira (EU USA also sold as Trudexa in EU) (adalimumab r (anti-TNF) human monoclonal antibody created using phage display technology Cambridge Antibody Technologies Abbott (USA) Abbott (EU) Rheumatoid arthritis... 

Humira Adalimumab Abbott Laboratories, North Chicago, IL Anti-TNF Rheumatoid arthritis 2002... 

Examples of antibodies in the market include trastuzumab (anti-HER2 monoclonal antibody), rituximab, natalizumab (x4-integiin antibody), abciximab, infiximab (targets TNF-a in Crohn s disease and rheumatoid arthritis), alemtuzumab, adalimumab (TNF-a antibody for the treatment of rheumatoid arthritis) and efalizumab (anti-CDlla monoclonal antibody for the treatment of psoriasis)Rituximab is a mouse/human chimeric anti-CD20 monoclonal antibody used for the treatment of various l)unphoid malignancies. As CE)20 antigen is found on the surface of... 

Adalimumab is a recombinant, fully human antitumor necrosis factor monoclonal antibody approved in the US and Europe for the treatment of adult patients with moderate to severe, active rheumatoid arthritis. It has to be injected subcutaneously. The most common side effects of adalimumab are injection site reactions. Adalimumab increases the risk of rare serious infections. Rare side effects include worsening or initiation of congestive heart failure, a lupus-like syndrome, a promotion of lymphoma, medically significant cytopenias, and worsening or initiation of a multiple sclerosis like neurological disease. 

Adalimumab is given subcutaneously and has a half-life of 10-20 days. Its clearance is decreased by more than 40% in the presence of methotrexate, and the formation of human antimonoclonal antibody is decreased when methotrexate is given at the same time. The usual dose in rheumatoid arthritis is 40 mg every other week, although increased responses may be evident at higher dosages. In psoriasis, 80 mg is given at week 0, 40 mg at week 1, and then 40 mg every other week thereafter. 

Adalimumab is a completely human IgGi approved for use in rheumatoid arthritis. Like the other anti-TNF- biologicals, adalimumab blocks the interaction of TNF- with TNF receptors on cell surfaces it does not bind TNF-3. Pharmacodynamic studies showed that administration of adalimumab reduced levels of C-reactive protein, erythrocyte sedimentation rate, serum IL-6, and matrix metalloproteinases MMP-1 and MMP-3. In vitro, adalimumab lyses cells expressing TNF- in the presence of complement. Patients may self-administer single doses of the antibody subcutaneously, every other week. Adalimumab has a serum half-life of 2 weeks, which is increased by 29-44% in patients who are also taking methotrexate. 

Adalimumab is used to reduce signs and symptoms and progression of rheumatoid arthritis and psoriatic arthritis. It could be administered alone or in combination with methotrexate. The recommended dose for adults is 40 mg by subcutaneous injection, administered every other week. The most common side effect associated with the administration of adalimumab is injection site reaction. The most serious side effects resulting from treatment with this antibody include increased risk of infections and malignancies and neurological disorders. Additional side effects are the production of autoantibodies, immunogenicity and GI disorders. 

Bartelds GM, Wijbrandts CA, Nurmohamed MT, Stapel S, et al. 2007. Clinical response to adal-imumab Relationship to anti-adalimumab antibodies and serum adalimumab concentrations in rheumatoid arthritis. Ann Rheum Dis. 66 921-926. 

Finally, antibodies such as adalimumab (Humira) and infliximab (Remicade) have been developed that bind directly to tumor necrosis factor alpha (TNF-alpha), thereby preventing this cytokine from causing damage to joints and other tissues. These anti-TNF-alpha drugs are therefore helpful in autoimmune diseases such as rheumatoid arthritis their pharmacology is addressed in more detail in Chapter 16. 

The compound is indicated for the treatment of rheumatoid arthritis and decreases the rate of formation of new erosions. It is effective both as monotherapy and in combination with methotrexate. The usual dose is 40 mg every other week, though increased responses may be evident at higher dosages. Adalimumab is presently being tested in psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile chronic arthritis. 

Fig. 12.8 (A) Dose-response relationship for adalimumab following singledose administration in patients with rheumatoid arthritis. (Figure produced from data reported in [78]). (B) Simulated suppression of serum TNF-a following single-dose administration of adalimumab.

O. Sander, C. Binder, H. Fenner,Y. Bank-mann, R. Velagapudi, J. Kempeni, and H. Kupper. 2002. A single dose, placebo controlled study of the fully human antitumor necrosis factor-alpha antibody adalimumab (D2E7) in patients with rheumatoid arthritis./. Rheumatol. 29 2288-2298. 

NICE (National Institute for Health and Clinical Excellence) (2007) Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis. Available at http //www.nice.org.uk/nicemedia/pdf/TA130guidance.pdf [Accessed 2 July 2008]. 

Humira Adalimumab Abbott Laboratories 12/2002 Moderately to severely active rheumatoid arthritis CHO... 

Adalimumab Humira (Abbott) Rheumatoid arthritis psoriatic arthritis... 

Adalimumab Humira Antibodies in oncology Abbott fully human mAb TNF-a rheumatoid arthritis 2003 IgGl 5%... 

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