Tumor necrosis factor (TNF) has been implicated in a number of arthritic disease states, including
rheumatoid arthritis,
psoriatic arthritis, and
ankylosing spondylitis.
Adalimumab is the first fully human, high-affinity, recombinant
immunoglobulin G(1) (
IgG(1)) anti-TNF
monoclonal antibody.
Adalimumab in combination with
methotrexate or standard antirheumatic
therapies, or as monotherapy, is effective in the treatment of adults with active
rheumatoid arthritis who have had an inadequate response to
disease-modifying antirheumatic drugs.
Adalimumab is also effective in the treatment of patients with moderately to severely active
psoriatic arthritis, improving both joint and
skin manifestations of the disease as well as disability due to joint damage. In the
Adalimumab Trial Evaluating Long-term Efficacy and Safety in
Ankylosing Spondylitis (ATLAS),
adalimumab significantly reduced the signs and symptoms of active
ankylosing spondylitis and established a sustained clinical response in patients who had an inadequate response or intolerance to nonsteroidal antiinflammatory
drug therapy. Overall, across these indications,
adalimumab demonstrated a rapid onset of action, sustained efficacy with long-term treatment, and was well-tolerated, with few patients discontinuing treatment because of adverse events. The safety profile was similar to other
TNF antagonists. Inhibition of TNF activity by
adalimumab also significantly improved physical functioning and quality of life measures.