Humira (adalimumab) is a biologic medicine that helps the pain and swelling of arthritis. It works by blocking TNF (Tumor Necrosis Factor), a type of signalling protein (called a cytokine), that is involved in systemic inflammation. Humira belongs to a class of similar medications called “Anti-TNF” agents.
Humira is used to treat Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Juvenile Inflammatory Arthritis, Psoriasis, Crohn’s Disease, and other types of arthritis. It may also be used to treat other diseases outside of rheumatology.
Humira is available as a subcutaneous (under the skin) injection in one of two forms: as a pre-filled syringe, and as an autoinjector (pen). The standard dose of each injection is 40 mg. It is usually taken every other week, but it can be prescribed every week to some patients.
Subcutaneous injections are easy to do compared to other types of injections. Patients can do them quickly at home. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
Learn how take Humira:
- Learn how to inject: subcutaneous injections
- Learn how to inject: autoinjectors (Enbrel “Sureclick”)
Humira usually takes about 2 weeks before patients start to feel its effects. It may take 12 weeks to feel the effect of this medicine.
Humira may be prescribed in combination with other rheumatology medications like methotrexate.
Important Tests and Risks
Humira can make it a bit harder for people to fight off infections. People taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Patients should coordinate with their doctor to stop treatment before any surgery, and re-start once things have healed and there’s no sign of infection.
Patients should discuss all vaccinations with their doctor because some are not advisable to get while taking Humira.
It is important to get a TB (tuberculosis) skin test and a chest x-ray before starting treatment.
Patients who are taking Humira should get occasional blood tests as requested by their doctor to keep track of their arthritis and make sure that blood counts are ok.
Drug Identification Number (DIN): 02258595 (SC)
How Humira Works
In some people with arthritis, a signalling protein (cytokine) called Tumour Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain and swelling).
Humira is another type of protein called a monoclonal antibody that works as a TNF blocker. It binds to TNF and prevents it from working. Normally TNF would bind to TNF receptors and cause inflammation.
In blocking TNF, Humira suppresses the body’s immune system. Though this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system and control arthritis.
Side Effects of Humira
People taking Humira should talk to their doctor if they are concerned about any side effects.
MORE COMMON side-effects include:
- Mild skin reaction at the injection site (itchiness, redness, and mild swelling).
- Nausea, abdominal pain
- Upper respiratory tract infections (such as sinusitis).
RARE side-effects include:
- Infection – There is an increased risk of serious infections while taking Humira. Any infections or fevers should be taken seriously and reviewed by a doctor.
- Nervous System – There have been rare reports of some patients developing disorders that affect the nervous system while taking Humira, such as: multiple sclerosis, seizures, or inflammation of the nerves of the eye. Fortunately, these reports are exceedingly rare.
- Heart – Patients should make sure their doctor knows if they have congestive heart failure as Humira can make it worse.
- Blood Counts – Humira can cause a drop in the numbers of white blood cells (which are needed to fight infection) or red blood cells (which carry oxygen). This is very rare and it is unusual for this to be a serious problem.
- Malignancy – Humira has been associated with a small increased risk of developing cancer (<1%).
How to minimize the side-effects of Humira:
- Patients should take Humira as prescribed by their doctor.
Who Should NOT Take Humira
Patients who should NOT be taking Humira (adalimumab) include:
- Patients who have had a previous serious allergic reaction to this medication
- Possibly patients who have cancer or have had a past history of certain cancers
- Patients who have severe or uncontrolled congestive heart failure
- Patients who have Lupus or multiple sclerosis
- Patients with active infections (such as tuberculosis)
- Patients already taking a medication that is also a “TNF blocker”
Patients should discuss all vaccinations with their doctor as some vaccines are not advisable while taking Humira.
Patients who are planning for surgery should tell their doctor.
Patients who become pregnant while taking Humira should notify their doctor.
When to Call a Doctor
Patients taking Humira (adalimumab) should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons for people taking Humira to call their doctor include:
- Fever or possible infection
- If another doctor has prescribed antibiotics to fight an infection
- Before having surgery
- Planning to get any vaccinations
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Humira.