Humira is a biological DMARD (Disease Modifying Anti-Rheumatic Drug). Humira is an Anti-TNF (Tumour necrosis factor) and it is self injected once every fortnight. Humira is prescribed for moderate to severe Rheumatoid Arthritis, in cases where cheaper medications (such as methotrexate, arava or sulfasalazine) have failed to provide benefit.
How does it work?
Tumour necrosis factor is a protein that promotes inflammation and is found in the synovial fluid and blood of patients suffering inflammatory arthritis. Humira is a human antibody that blocks this protein, thereby reducing the inflammation and the signs and symptoms associated with it (swelling, pain, tenderness)
Humira is available in pre-filled syringes and a pen auto injector. The usual dose is 40mg self-injected fortnightly.
Humira Side effects
The most common side effects are injection site reactions – redness, swelling, itching and bruising. This is usually mild, but if it lasts for more than 5 days or is severe, a doctor should be consulted.
Also common are nausea, headache, rash and abdominal pain and bloating.
Humira suppresses the immune system, so infections are common, as are minor infections becoming more serious. Humira has also been associated with serious infections such as tuberculosis, sepsis and fungal infections. Though rare, these infections can be fatal. Humira may also cause or worsen diseases of the nervous system, such as Multiple Sclerosis. Humira also raises the risk of some cancers.
A full list of side effects is available here.
No special monitoring is necessary. Humira should be discontinued if an infection develops (e.g. fever) until all signs of infection are gone.
Patients much be tested for tuberculosis before starting Humira. Humira is an immune system supressant, and patients suffering serious infections should not receive Humira. Invasive fungal infections (such as histoplasmosis) and other opportunistic infections may be worsened by Humira and in some instances have been fatal.
Patients with pre-existing disease of hte nervous system, such as Multiple Sclerosis should not take Humira.
Advice in pregnancy/breastfeeding
Humira has not been studies in pregnancy or breast feeding women, and therefore is avoided.