Monitoring of Adalimumab Therapy

Routine Monitoring

1. Usual tests for methotrexate or other DMARD
2. If monotherapy CBC/LFT at 1,3 and 6 months, then 3 monthly
3. ANA yearly

Indications for Stopping Therapy: Stop if:

1. Evidence of infection
2. Possible demyelination
3. SLE / new autoimmune syndrome
4. Severe injection site reaction (If minor reaction try oral anti-histamine or topical corticosteroids)
5. Rash - caution very rarely Steven Johnsons Syndrome

WCC < 2.0 109/L or below local normal range

Platelets 3 times normal range (iu/L)

Neutrophils < 2.0 109/L or below local normal range

AST or ALT > 3 times normal range (iu/L)

Vaccinations

1. +/- Influenza and pneumococcal vaccination
2. +/- Standard vaccinations avoiding live and live-attenuated vaccines