Hukyndra (Adalimumab)

Hukyndra is indicated for several autoimmune and inflammatory conditions where TNF‑alpha plays a key role.

• Rheumatoid arthritis in adults.
• Psoriatic arthritis and related joint disease.
• Ankylosing spondylitis, a form of axial spondyloarthritis.
• Moderate to severe plaque psoriasis.
• Crohn’s disease and ulcerative colitis when other therapies are insufficient.
• Hidradenitis suppurativa that is refractory to conventional treatment.

• Adalimumab is a fully human monoclonal antibody that selectively binds soluble and membrane‑bound tumor necrosis factor‑alpha (TNF‑α). By attaching to TNF‑α, it prevents the cytokine from interacting with its cell‑surface receptors, thereby inhibiting downstream signaling pathways that drive inflammation, cell recruitment, and tissue damage. This blockade reduces the inflammatory cascade characteristic of autoimmune diseases. The neutralization of TNF‑α also diminishes activation of endothelial cells and production of other pro‑inflammatory mediators such as interleukin‑1 and interleukin‑6.

Adalimumab may cause a range of adverse reactions, most of which are mild to moderate, while rare events can be serious.

Common

• Injection site pain, redness, or swelling.
• Upper respiratory tract infections (e.g., nasopharyngitis).
• Headache.
• Mild rash or itching.

Serious

• Serious infections such as tuberculosis, bacterial sepsis, or fungal infections.
• Reactivation of hepatitis B virus.
• Development of malignancies, including lymphoma or skin cancer.
• Severe allergic reactions, including anaphylaxis or angioedema.

Before starting Hukyndra, healthcare providers assess several safety considerations to minimize risks associated with immunosuppression.

• Screen for latent tuberculosis and treat before initiating therapy.
• Evaluate for active infections; postpone treatment if serious infection is present.
• Assess hepatitis B status and monitor during therapy.
• Use caution in patients with a history of malignancy.
• Monitor for signs of demyelinating disease or neurological symptoms.
• Discuss pregnancy and breastfeeding plans, as safety data are limited.

Adalimumab can interact with other medicines, affecting infection risk or immune response, so review concomitant drugs carefully.

Avoid

• Live‑attenuated vaccines (e.g., measles, varicella) during treatment.
• Concurrent use of other biologic immunosuppressants (e.g., abatacept, rituximab) without specialist guidance.

Use with caution

• Systemic corticosteroids, which may increase infection risk.
• Immunomodulators such as methotrexate or azathioprine.
• Antifungal agents that require immune competence.
• Drugs that affect hepatic metabolism are generally not a concern, but monitor liver function if indicated.