Published online Mar 9, 2016. doi: 10.5497/wjp.v5.i1.44
Peer-review started: October 6, 2015
First decision: October 27, 2015
Revised: November 19, 2015
Accepted: December 13, 2015
Article in press: December 14, 2015
Published online: March 9, 2016
Anti-tumor necrosis factor (TNF) drugs are widely prescribed for inflammatory disease. A loss of response to adalimumab is frequent and the pharmacokinetics of anti-TNF therapy have important implications for patient management. Individual factors such as albumin, body weight, and disease severity based on the C-reactive protein level influence drug metabolism. Adalimumab trough levels are associated with clinical remission. On the other hand, the detection of antibodies is associated with clinical relapse. Immunosuppressive therapy could reduce antibody formation although the clinical impact is not proven. New algorithms are available to provide personalized treatment and adapt the dosage. More data are needed on dose de-escalation.
Core tip: We have reviewed all the recent data about the factors that influence Adalimumab pharmacokinetics and the impact for the clinicians in the assessment of inflammatory disease. We looked at the inter patient variability, the drug clearance, antibodies detection, the effect of concomitant use of immunosuppressive.