Name of the Procedure:

Adalimumab (also known by the brand name Humira)

Summary

Adalimumab is a medication administered via injection to help reduce inflammation in the body. It is commonly used to treat various autoimmune conditions by targeting and inhibiting specific proteins that trigger inflammatory responses.

Purpose

Adalimumab is used to address autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, and plaque psoriasis. The goal is to reduce symptoms such as pain, swelling, and stiffness, and to improve overall function and quality of life.

Indications

Adalimumab is indicated for:

• Moderate to severe rheumatoid arthritis
• Moderate to severe Crohn's disease
• Psoriatic arthritis
• Ankylosing spondylitis
• Moderate to severe ulcerative colitis
• Chronic plaque psoriasis
• Juvenile idiopathic arthritis

Patients suitable for Adalimumab are those who have these conditions and have not responded adequately to other treatments.

Preparation

• Patients are usually asked to stop or adjust certain medications.
• Baseline tests, like blood work and TB screening, may be required.
• Patients should consult with their healthcare provider about any ongoing infections or history of TB, hepatitis B, or other significant diseases.

Procedure Description

1. The medicine is typically administered as a subcutaneous injection.
2. Patients or caregivers are trained to give the injection at home.
3. The injection site (thigh or abdomen) is cleaned with an alcohol swab.
4. The pre-filled syringe or pen is used to inject the medication under the skin.
5. Injection sites are rotated to avoid irritation.

Duration

Each injection takes a few minutes. Adalimumab is usually administered once every two weeks, although the schedule might vary based on the condition and response to the treatment.

Setting

Adalimumab injections can be performed in various settings, including at home by the patient or caregiver, or in a clinical setting under the supervision of healthcare professionals.

Personnel

• Initially administered or supervised by a healthcare provider, such as a nurse or doctor.
• Patients or caregivers trained to perform the injections at home.

Risks and Complications

• Common: Injection site reactions (redness, swelling, pain), headache, rash
• Rare: Serious infections (TB, fungal, viral, bacterial), allergic reactions, liver problems, blood disorders, increased risk of certain cancers
• Management of complications includes stopping the medication and seeking immediate medical advice.

Benefits

Expected benefits include reduced painful and inflammatory symptoms, improved physical function, and slowed disease progression. Benefits may be seen within a few weeks to a few months, depending on the condition.

Recovery

• Post-injection, patients may experience mild soreness or swelling at the injection site.
• Normal activities can usually be resumed immediately, but patients should monitor for any adverse reactions.
• Regular follow-up appointments and blood tests may be necessary to monitor the drug’s effectiveness and side effects.

Alternatives

• Other biologics: etanercept (Enbrel), infliximab (Remicade)
• Non-biologic DMARDs (Disease-Modifying Anti-Rheumatic Drugs): methotrexate, sulfasalazine
• Systemic corticosteroids
• Pros and cons vary: biologics may have similar efficacy but different side-effect profiles; non-biologics may be less effective but have different risk factors.

Patient Experience

• Initial training for self-administration is required.
• The injections might cause slight discomfort, but this can be managed with proper technique and site rotation.
• Post-injection, most patients can return to their normal routines with minimal disruption.
• Pain management and comfort measures, like applying an ice pack to the injection site, can improve the patient experience.