Active substance/effect of Adalimumab

Adalimumab belongs to the so-called biologicals, a group of still relatively new drugs, which have a regulatory influence on our body’s immune system. Strictly speaking, Adalimumab belongs to the so-called tumour necrosis factor-alpha inhibitors, which are generally used for chronic inflammatory, systemic – i.e. affecting the whole body – diseases where the standard therapy has failed. Adalimumab inhibits the body’s own messenger substance tumor necrosis factor alpha, which is involved in the development of inflammation.

Inflammations serve, for example, when pathogens enter the body, to kill them and prevent them from spreading into the body’s circulation. In this way bad infections can be prevented by our immune system, even if some of the body’s own cells die in the process. However, it can happen that our immune system is misregulated and not only regards foreign cells as a threat, but also the body’s own cells.

If these are then attacked by our immune system, inflammations arise and these lead to the destruction of cells. For example, in rheumatic diseases, this can lead to the destruction of joints with severe pain and restricted movement. In this case Adalimumab can intervene in the development of the inflammation by inhibiting one of the messenger substances and can thus reduce the inflammatory activity. In this way, healthy endogenous cells can be maintained and the progress of chronic inflammatory diseases can be slowed down.

These are possible side effects

Adalimumab is a drug which is accompanied by numerous serious side effects. The most important side effect is related to the mode of action: The body’s own defence system is inhibited by Adalimumab – in this context it is also called immunosuppression. This effect is certainly desired in chronic inflammatory diseases, which are caused by the hypersensitivity of the immune system to the body’s own cells, but it also means that the body’s own defence against pathogens is reduced.

Patients thus more frequently fall ill with viral or bacterial infections, which can also be accompanied by increased complications such as pneumonia or blood poisoning (sepsis) due to the weakened immune system. If patients have an inactive and symptomless tuberculosis infection, it can be reactivated by taking adalimumab. Apart from defending against pathogens, the immune system is also responsible for fighting tumour cells.

Every day it recognizes degenerated cells (i.e. cells that suddenly begin to divide excessively due to defects and can thus lead to cancer) and destroys them before a tumor can develop. However, since adalimumab suppresses the immune system, patients have an increased risk of developing cancer. Adalimumab also has an effect on the development of blood cells.

Thus, a decrease of red and white blood cells (a so-called anemia and leukopenia) can occur when taking Adalimumab. The number of blood platelets (thrombocytes), which are responsible for blood clotting, can also drop. An increased bleeding tendency is the result.

Also known are side effects on the gastrointestinal tract such as nausea, abdominal pain and vomiting. Headache, joint pain and muscle pain are also described. Finally, as with any other medication, an allergic reaction can occur when taking adalimumab.

Many patients wonder whether they will gain weight under the therapy with Adalimumab. Often the patients have previously taken cortisone, which is known for increased appetite and thus often weight gain. From the official side there is no weight gain listed for Adalimumab in the side effects.

Especially due to a dose reduction of cortisone by using adalimumab many patients report that they could lose weight again. However, it should be noted that adalimumab can lead to water retention, so-called oedema. In this case the scale shows more weight, but then it is only water and not fat mass.

Adalimumab is a medicine with many possible side effects, which can occur, but are by no means pronounced in every patient. In the package insert for Adalimumab, mood swings are listed as frequent (affects 1 in 10 people), which can also include depression. If you notice longer episodes of loss of interest, sadness or exhaustion during therapy, you should not be afraid to talk to your doctor about it and treat a possible depressive episode in time.

Hair loss is also one of the more common side effects of Adalimumab. The extent of the hair loss is very different. If you notice a beginning hair loss, it is also advisable to talk to your doctor, so that he can clarify the exact cause and discuss treatment options.