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)


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