Assay

Adalimumab

Key Words

Adalimumab

Specimen Collection

Serum (Brown)

Turnaround time

14 days

This test is referred to another centre:

Department of Clinical Biochemistry

City Hospital

Dudley road

Birmingham

B18 7QH

0121 507 3441

Test indications

Adalimumab is a humanised monoclonal antibody directed against tumour necrosis factor alpha (TNF). Anti-TNF therapy has become an important alternative treatment in the management of patients with chronic inflammatory diseases such as rheumatoid arthritis (RA), Crohn’s disease (CD), and ankylosing spondylitis (AS).

The relationship between serum trough levels of anti-TNF drug and clinical improvement has been identified indicating that it can be used as a therapeutic monitoring tool. Within a given population of patients a significant number have been noted to develop resistance to the drug and show undetectable trough levels of Adalimumab.

The main indication for undertaking the test is lack of clinical response to the Adalimumab. A trough serum concentration of <5 µg /mL, in a patient on Adalimumab, indicates subtherapeutic levels. If anti-drug antibodies are present, a change in drug therapy should be considered. In patients with low levels of Adalimumab but absent antibodies, a review of the treatment regimen may be required once non-compliance has been excluded.

Antibodies will only be tested if indicated by a trough serum concentration of <5.0 µg/mL

Methodology

ELISA

Interferences

Contact referral lab

Reference Range

Trough therapeutic cut-off : >5.0 µg/mL

Analytical error

Contact referral lab

Reference change value

Contact referral lab