Adalimumab and anti-adalimumab antibody

Alternative names, keywords

Anti-TNF alpha drugs, Humira, Hyrimoz, Yuflyma, Imraldi, Amgevita.

Samples required

● Clotted blood (gold cap, 5 mL tube). Smaller tubes are available for paediatric samples.

Trough level recommended (immediately before the next dose is due).

For prompt referral of sample please specify which drug patient is on.

Test indications

Primary treatment failure (non-response), secondary loss of response, prediction of infusion reactions, adherence to therapy , reintroduction after drug interruption.

Test information

Interpretation requires full clinical details: drug dosage/ frequency, previous exposure to other biologics, time of sampling, duration of therapy and clinical assessment.

Reference range

Suggested target drug concentrations for adalimumab in the treatment of IBD:

Induction/post-induction:

Week 4 to target: 8 - 12 ug/mL

Maintenance to target: 8 - 12 ug/mL

Target concentrations are based on Cheifetz* et al. (2021) and apply only to inflammatory bowel disease. All TDM thresholds are estimates based on population data. Results should always be interpreted in the context of the clinical situation.

_{*Cheifetz et al, Am J Gastroenterol 2021;116:2014-2025.}

In the presence of drug levels greater than 5 µg/mL, free anti-drug antibody cannot be detected and therefore its measurement is not indicated.

Anti-adalimumab antibody: 0 - 10 ng/mL

Turnaround time

Referral lab quotes turnaround time of 2 weeks, however additional time must be allowed for packing, dispatch and delivery of sample, and return and processing of results.

Enquiries

Biochemistry (Referrals)