Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Pharmacol. Mar 9, 2016; 5(1): 44-50
Published online Mar 9, 2016. doi: 10.5497/wjp.v5.i1.44
Adalimumab and pharmacokinetics: Impact on the clinical prescription for inflammatory bowel disease
Anne-Laure Pelletier, Pascale Nicaise-Roland
Anne-Laure Pelletier, Department of Hepato-gastroenterology, Hôpital Bichat-Claude Bernard, 75018 Paris, France
Pascale Nicaise-Roland, Department of Immunology Autoimmunité et Hypersensibilités, Hôpital Bichat-Claude Bernard, 75018 Paris, France
Author contributions: All authors contributed equally to this paper with literature review, analysis, drafting and critical revision, editing and final approval of the final version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or the coauthor who contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Anne-Laure Pelletier, MD, Hospital Practitioner, Department of Hepato-Gastroenterology, Hôpital Bichat-Claude Bernard, 46 rue Huchard, 75018 Paris, France.
Telephone: +33-1-40257200 Fax: +33-1-40258783
Received: September 22, 2015
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.

Keywords: Pharmacokinetics, Adalimumab, Crohn’s disease

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.