Skip to main content
Log in

Adalimumab

In Non-Radiographic Axial Spondyloarthritis

  • Adis Drug Profile
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

Adalimumab is a fully human, recombinant, monoclonal IgGl antibody specific for the cytokine tumour necrosis factor-α. It is approved for the treatment of various inflammatory disorders, including severe non-radiographic axial spondyloarthritis (axSpA).

The clinical efficacy of adalimumab (40 mg administered subcutaneously every other week) in adult patients meeting the Assessment of SpondyloArthritis international Society (ASAS) criteria for axSpA but not the modified New York criteria for ankylosing spondylitis (AS) has been demonstrated in the pivotal phase III, randomized, double-blind, placebo-controlled ABILITY-1 trial (n = 192 randomized).

In ABILITY-1, adalimumab was effective in improving the signs and symptoms of non-radiographic axSpA in patients who had active disease despite treatment with NSAIDs or who were intolerant to, or had a contraindication for, NSAIDs. Compared with placebo, a significantly greater proportion of patients receiving adalimumab 40 mg every other week achieved an ASAS 40 response after 12 weeks of treatment (primary endpoint). Furthermore, adalimumab significantly decreased inflammation in the spine and sacroiliac joints, as measured by MRI, and improved spondyloarthritic and general measures of health-related quality of life at 12 weeks.

Efficacy of adalimumab was sustained over the longer term, according to data at 68 weeks from an open-label extension of ABILITY-1.

Adalimumab was generally well tolerated in clinical trials of non-radiographic axSpA; the adverse event profile was similar to that in patients with AS or other approved indications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Heldmann F, Dybowski F, Saracbasi-Zender E, et al. Update on biologic therapy in the management of axial spondyloarthritis. Curr Rheumatol Rep 2010 Oct; 12(5): 325–31

    Article  PubMed  CAS  Google Scholar 

  2. Colbert RA. Early axial spondyloarthritis. Curr Opin Rheumatol 2010 Sep; 22(5): 603–7

    Article  PubMed  Google Scholar 

  3. Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 2009 Jun; 68 Suppl. II: ii1–44

    Article  PubMed  Google Scholar 

  4. Rudwaleit M, Sieper J. Referral strategies for early diagnosis of axial spondyloarthritis. Nat Rev Rheumatol 2012 May; 8(5): 262–8

    Article  PubMed  CAS  Google Scholar 

  5. LaSalle SP, Deodhar AA. Appropriate management of axial spondyloarthritis. Curr Rheumatol Rep 2007 Oct; 9(5): 375–82

    Article  PubMed  CAS  Google Scholar 

  6. European Medicines Agency. Committee for Medicinal Products for Human Use (CHMP) assessment report for Humira (adalimumab): procedure no. EMEA/H/C/000481/ II/0085 [online]. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Assessment_Report_-_Variation/human/000481/WC500131935.pdf [Accessed 2012 Nov 28]

  7. Lukas C, Landewe R, Sieper J, et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 2009 Jan; 68(1): 18–24

    Article  PubMed  CAS  Google Scholar 

  8. The National Ankylosing Spondylitis Society. The Bath indices: outcome measures for use with ankylosing spondylitis patients [online]. Available from URL: http://www.nass.co.uk/NASS/en/loose-leaf-pages/bath-indices/ [Accessed 2012 Nov 28]

  9. Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A, et al. Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis 2003 Feb; 62(2): 127–32

    Article  PubMed  CAS  Google Scholar 

  10. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984 Apr; 27(4): 361–8

    Article  PubMed  Google Scholar 

  11. European Medicines Agency. Humira 40 mg solution for injection: summary of product characteristics [online]. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000481/WC500050870.pdf [Accessed 2012 Nov 28]

  12. Abbott Laboratories. Humira (adalimumab): US prescribing information [online]. Available from URL: http://www.rxabbott.com/pdf/humira.pdf [Accessed 2012 Nov 28]

  13. Simpson D, Scott LJ. Adalimumab: in psoriatic arthritis. Drugs 2006 Aug; 66(11): 1487–96

    Article  PubMed  CAS  Google Scholar 

  14. Cvetkovic RS, Scott LJ. Adalimumab: a review of its use in adult patients with rheumatoid arthritis. BioDrugs 2006 Oct; 20(5): 293–311

    Article  PubMed  CAS  Google Scholar 

  15. Croom KF, McCormack PL. Adalimumab: in plaque psoriasis. Am J Clin Dermatol 2009 Jan; 10(1): 43–50

    Article  PubMed  Google Scholar 

  16. Plosker GL, Lyseng-Williamson KA. Adalimumab: in Crohn’s disease. BioDrugs 2007 Apr; 21(2): 125–32

    Article  PubMed  CAS  Google Scholar 

  17. Bang LM, Keating GM. Adalimumab: a review of its use in rheumatoid arthritis. BioDrugs 2004 Mar; 18(2): 121–39

    Article  PubMed  CAS  Google Scholar 

  18. den Broeder AA, Joosten LA, Saxne T, et al. Long term anti-tumour necrosis factor alpha monotherapy in rheumatoid arthritis: effect on radiological course and prognostic value of markers of cartilage turnover and endothelial activation. Ann Rheum Dis 2002 Apr; 61(4): 311–8

    Article  Google Scholar 

  19. Haibel H, Rudwaleit M, Listing J, et al. Efficacy of adalimumab in the treatment of axial spondylarthritis without radiographically defined sacroiliitis: results of a twelve-week randomized, double-blind, placebo-controlled trial followed by an open-label extension up to week fifty-two. Arthritis Rheum 2008 Jul; 58(7): 1981–91

    Article  PubMed  CAS  Google Scholar 

  20. Sieper J, van der Heijde D, Dougados M, et al. Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1). Ann Rheum Dis. Epub 2012 Jul 7

    Google Scholar 

  21. Emi Aikawa N, de Carvalho JF, Artur Almeida Silva C, et al. Immunogenicity of anti-TNF-alpha agents in autoimmune diseases. Clin Rev Allergy Immunol 2010 Apr; 38(2–3): 82–9

    Article  PubMed  CAS  Google Scholar 

  22. European Medicines Agency. Humira-H-C-481-II-26: EPAR-scientific discussion-variation [online]. Available from URL: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion_-_Variation/human/000481/WC500050874.pdf [Accessed 2012 Nov 28]

  23. Maksymowych WP, Mease PJ, Rao S, et al. Effect of adalimumab on function, health-related quality of life, work productivity, and daily activities in patients with non-radiographic axial spondyloarthritis [abstract no. 1312]. Arthritis Rheum 2011 Oct; 63 Suppl. 10: s513

    Google Scholar 

  24. Sieper J, van Der Heijde D, Dougados M, et al. Sustained efficacy of adalimumab in patients with non-radiographic axial spondyloarthritis: week 68 results from ABILITY 1 [abstract no. THU0275]. Ann Rheum Dis 2012; 71 Suppl. 3: 248

    Google Scholar 

  25. Haibel H, Heldmann F, Rudwaleit M, et al. Long-term efficacy of adalimumab for patients with active, non-radiographic, axial spondyloarthritis who relapsed following adalimumab withdrawal [abstract no. OP0027]. Ann Rheum Dis 2010 Jun; 69 Suppl. 3: 59

    Google Scholar 

  26. Abbott. Study of adalimumab in subjects with axial spondyloarthritis [ClinicalTrials.gov identifier NCT00939003]. US National Institutes of Health, ClinicalTrials.gov [online]. Available from URL: http://clinicaltrials.gov [Accessed 2012 Nov 28]

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Celeste B. Burness.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burness, C.B., Deeks, E.D. Adalimumab. Drugs 72, 2385–2395 (2012). https://doi.org/10.2165/11470250-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11470250-000000000-00000

Keywords

Navigation