Adalimumab

Description: 
The measurement of Adalimumab is a useful tool in managing patients who fail to respond (primary failure) or who go on to lose response (secondary failure) to treatment. Monitoring drug levels allows for a personalised approach to drug optimisation by appropriate dose escalation/de-escalation or drug switching/withdrawal.

Measured alone or as part of a profile including anti-Adalimumab antibodies.
Clinical details: 
Adalimumab is a fully humanised monoclonal antibody which specifically targets tumour necrosis factor alpha (TNFα). Adalimumab is licensed for use in Gastroenterology (Crohn's diseases, ulcerative colitis), Rheumatology (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis) and Dermatology (sever plaque psoriasis). Due to its high cost, Adalimumab is only indicated in patients with severe disease which is refractory to conventional therapeutic approaches.
Reference range: 

Lower limit of the therapeutic range is yet to be established, however levels of greater than 5 µg/mL appear to be adequate.This information will be updated as we refine the therapeutic range. Test interpretation requires full clinical information: drug dosage/frequency, previous exposure to other biologics, time of sampling, duration of therapy and clinical assessment.

Units: 
µg/mL
Sample type and Volume required: 
Serum or plasma. Collect blood into a serum separation (SST™), plain or lithium heparin tube. Minimum 300μL serum or plasma required for both drug and anti-drug antibody analysis.
Turnaround time: 
2 weeks
Special sample instructions: 

Collect blood into a serum separation (SST™) or plain tube, preferably shortly before drug administration (trough levels). Centrifuge sample at 3000 rpm for 10 minutes, aliquot serum or plasma and keep in fridge until transport. If transport is going to be delayed by > 5 days, freeze at -20°C and send by first class post at a later date.

Storage and transport: 
Post the sample to GSTS Pathology by first class post.
Contacts:
Reference Chemistry Laboratory at St Thomas'
0207 188 1264
4th floor, North Wing
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH
For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 26/10/2017