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Arthritis health centre


BMJ Group Medical Reference


This information is for people who have rheumatoid arthritis. It tells you about adalimumab, a treatment used for rheumatoid arthritis. It is based on the best and most up-to-date research.

Does it work?

We know that adalimumab works better than a dummy drug (a placebo).

But we don't know if it works as well as the other drugs used for rheumatoid arthritis. There hasn't been enough research to tell.

You'll probably be offered adalimumab only if you've already tried other types of drug.

What is it?

Adalimumab is a type of medicine called an anti-TNF drug. Like some of the other treatments for rheumatoid arthritis, anti-TNF drugs don't just help with pain. They also slow down the damage to your joints. Drugs that do this are called disease-modifying anti-rheumatic drugs (DMARDs for short). Anti-TNF drugs are a newer type of DMARD. You may also hear them called biologic drugs, or biologic.

Adalimumab (brand name Humira) is given as an injection under your skin, usually every two weeks.

Several other anti-TNF drugs are also available in the UK. To find out about these, see our information on infliximab plus methotrexate, etanercept, certolizumab, and golimumab.

Guidelines for doctors say you should only be offered adalimumab if you have not been helped by two other DMARDs. One of the DMARDs that you should have tried is methotrexate. You may also be offered these drugs if you can't take other drugs because of side effects. [41] You should also have a check-up every six months to make sure the drug is working.

How can it help?

Adalimumab can help reduce pain and swelling in your joints more than a dummy ( placebo) drug. [92] [93] [94]

But we don't know if it works as well as the other drugs used for rheumatoid arthritis. There hasn't been any research comparing it with other DMARDs or steroids.

How does it work?

TNF (or tumour necrosis factor) is a chemical in your blood. Anti-TNF drugs stop this chemical working. Scientists think that this chemical makes your immune system attack the lining of your joints. This causes swelling and pain.

Can it be harmful?

Studies suggest adalimumab is safe in the short term. [94] [93] [92] But we need more long-term studies to be sure it's safe to take for a long time.

One study showed that people taking adalimumab may be more likely to get a condition called shingles, which causes painful blisters. Shingles can only happen if you've had chickenpox in the past. It happens when the immune system no longer keeps the virus that caused chickenpox, called the herpes zoster virus, in check. [48]

Adalimumab and other anti-TNF drugs may slightly increase the risk of some kinds of cancer, including lymphoma and leukaemia. [45] It's difficult to say how big the risk is. In the US from 2001 to 2008, there were 48 reports of cancer in children and teenagers taking anti-TNF drugs, and 147 cases of leukaemia in both adults and children. That's out of many thousands of people who were taking these medicines. Most people were also taking other drugs that affected their immune system, so it's not clear how much of a part anti-TNF drugs played. We also found a summary of the evidence (systematic review) that looked at 21 studies and eight shorter reports of the effects of anti-TNF drugs. [46] It didn't show that patients using anti-TNF drugs were more likely to get most sorts of cancer, but they did have a higher risk of getting some types of skin cancer.

Last Updated: August 15, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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