Adalimumab, sold under the brand name Humira, is a biologic medication that belongs to a class of drugs called TNF-alpha inhibitors or disease modifying anti rheumatic drugs (DMARDS). It works by blocking tumour necrosis factor-alpha, a protein involved in driving inflammation in autoimmune conditions. It’s prescribed for a range of chronic inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, Crohn’s disease, and ulcerative colitis. It’s given as a subcutaneous injection, usually every one to two weeks depending on the condition being treated and the person’s response. It does not work immediately, instead you notice a slow and steady improvement in mobility and pain relief. The down side is that they significantly reduce the immune response, rendering small infections and illnesses much more serious for people taking this medicine and its relatives.
Access
I was diagnosed with Ankylosing Spondylitis after over time experiencing decreased mobility and pain over time. For me it was in the sacroiliac joints and lower spine. It meant getting going could be hard and some sports that I loved like kayaking became difficult. X-rays showed the telltale ossification and loss of cartilage. In Australia there are tight rules around this medicine, you need to fail or be unresponsive to two lower cost medicines . Sulfasalazine was one, it made me so nauseous it was hard to hold food down and Naproxen couldn’t be used due to lithium induced nephrotoxicity (see Lamotrigine ) , so I qualified. The rheumatologist can then get a PBS authorisation bringing the medicine cost from in the thousands to $30 per month.
Position in this vault
This medicine is a good one and such a technological breakthrough over past anti rheumatic drugs which were effectively chemotherapy drugs. It is in this vault because it provides a pain management modality that reduces or eliminates the need for opioid pain relief and the addiction profile they have, as well a their impact on recovery.