Monday, September 23, 2013

Doctor, Should I Take Humira for My Rheumatoid Arthritis?

TNF alpha is a cytokine, a unique protein that is produced during the inflammatory response. TNF alpha is not only the result of inflammation, it is also a substance that promotes the inflammation. Increased levels of TNF are found in several inflammatory conditions including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Drugs that block tumor necrosis factor (TNF) have been found to be particularly effective for the treatment of these serious forms of inflammatory arthritis.

Adalimumab (Humira) is constructed from a fully human monoclonal antibody. It binds to TNF alpha, preventing it from activating TNF receptors.

It acts like a barrier to the interaction between TNF alpha and receptors for TNF alpha on immune cells. This prevents TNF alpha from perpetuating inflammation and the pain, tenderness and swelling of joints in patients with different types of arthritis.

Humira reduces the signs and symptoms of rheumatoid arthritis, the arthritis of psoriasis, and ankylosing spondylitis. It also prevents the progression of joint destruction in patients with rheumatoid arthritis and the arthritis of psoriasis.

Humira can be used alone or in combination with methotrexate. The drug has been approved for use in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

It comes in a 40 mg prefilled syringe and is administered subcutaneously every two weeks. The syringe must be kept refrigerated.

Serious infections, including tuberculosis, have occurred in patients receiving Humira. In some cases, these infections have been fatal. Before starting the drug, a patient should be tested for TB. Any medication prescribed for the treatment of TB should start before beginning Humira and should be continued until the full course of medication is completed.

Since Humira suppresses important parts of the immune system, a patient should not receive vaccines containing live virus.

Having an infection could put a patient at risk for serious side effects from Humira.

TNF-blocking agents have been associated with reactivation of hepatitis B. Some cases have been fatal.

Rare cases of demyelinating syndromes such as multiple sclerosis have been reported.

Anti-TNF drugs should be used with caution in patients with congestive heart failure.

Combining Humira and Kineret (anakinra) is not recommended

Humira is contraindicated in pregnancy as well as for use in nursing mothers.

There have been rare cases of severe allergic reactions after taking Humira. Lymphoma and pancytopenia (low blood counts) have also been rarely reported in patients taking anti-TNF therapy.

The most common side-effects are injection site reactions, upper respiratory tract infections, headache, and nausea.

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