Hefiya (Adalimumab)

Hefiya (adalimumab) is indicated for several chronic inflammatory disorders, including those where suppression of tumor necrosis factor‑α is clinically beneficial.

• Rheumatoid arthritis in adults who have an inadequate response to conventional disease‑modifying antirheumatic drugs.
• Psoriatic arthritis for patients with active joint disease despite prior therapy.
• Ankylosing spondylitis in adults with active disease not controlled by NSAIDs.
• Moderate to severe Crohn’s disease refractory to conventional treatment.
• Moderate to severe ulcerative colitis unresponsive to standard therapy.
• Plaque psoriasis in adults requiring systemic treatment.

Adalimumab may cause a range of adverse reactions, which are generally categorized by frequency and severity overall.

Common

• Injection site reactions such as redness, swelling, itching, or pain at the administration site.
• Upper respiratory tract infections, including common cold, sinusitis, and nasopharyngitis.
• Headache, ranging from mild to moderate intensity.
• Nausea, often transient and mild.
• Fatigue or general feeling of tiredness, occasionally affecting daily activities.

Serious

• Serious infections, for example tuberculosis, bacterial sepsis, fungal infections, and opportunistic pathogens.
• Reactivation of hepatitis B in patients with prior infection.
• Malignancies, including lymphoma and other rare cancers.
• Demyelinating disorders such as multiple sclerosis‑like events.
• Exacerbation of congestive heart failure.

When prescribing Hefiya, clinicians should consider several precautionary measures to ensure patient safety and optimal therapeutic outcomes.

• Screen for active or latent tuberculosis before initiating therapy.
• Evaluate for chronic infections such as hepatitis B or C and manage accordingly.
• Assess patient history for demyelinating disease, heart failure, or malignancy.
• Monitor for signs of serious infection during treatment.
• Use caution in pregnant or breastfeeding women; discuss risks and benefits.
• Adjust dosing in patients with severe renal or hepatic impairment as recommended.

Adalimumab can interact with other medicines, potentially altering its efficacy or increasing safety risks.

Avoid

• Live vaccines should be avoided because immunosuppression from adalimumab can allow the attenuated pathogen to cause infection.
• Concomitant use with other biologic immunosuppressants (for example, abatacept or rituximab) is generally avoided due to a substantially increased risk of serious infections.

Use with caution

• Methotrexate or azathioprine may augment immunosuppressive effects; patients should be monitored for infection signs and blood counts.
• Antifungal agents such as azoles can affect the metabolism of adalimumab; dose adjustments may be necessary.
• Cyclosporine or tacrolimus may increase hepatic stress; liver function tests should be performed regularly.