Rheumatoid arthritis treatment adalimumab

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 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... 

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 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. 

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. 

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]. 

Keystone E C, Kavanaugh A F, Sharp J T, et al. (2004). Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy a randomized, placebo-controlled, 52-week trial. Arthrit. Rheumatism. 50 1400-1411. 

Tumorigenicity There is growing evidence linking TNF alfa antagonists with malignancies, but this has still to be clarified. Two primary malignant melanomas developed in a patient with rheumatoid arthritis after treatment with adalimumab [35 ]. 

Immunologic An IgE-mediated anaphylactic reaction has been attributed to anakinra in a 46-year-old Indian woman with rheumatoid arthritis who had had an urticarial rash and infusion reactions after three doses of infliximab, and autoantibodies, worsening Raynaud s phenomenon, and digital microinfarcts after treatment with etanercept for 1 year [83 ]. Skin prick tests were positive to both anakinra and histamine. She then had an urticarial reaction to adalimumab. 

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