Overview

Inflammatory bowel disease (IBD) is a term used to describe long-term conditions involving inflammation of the gut, including:

• ulcerative colitis
• Crohn's disease

The NHS website has more information about IBD.

Adalimumab (also known by brand names Humira^® or Idacio^®), is used to treat moderate to severe, and active Crohn's disease and ulcerative colitis.

It might be a suitable treatment when:

• other medicines have not worked
• you haven't reacted to other medicines well
• surgery is not the right option for you at this time

Treatment with adalimumab can improve symptoms and quality of life for people with IBD.

How it works

TNF-alpha is a protein that is produced by the body as part of its immune response. It can be partly responsible for the inflammation if it's overproduced.

Adalimumab is an antibody that reduces the activity of TNF-alpha by binding to it. This helps reduce inflammation and relieve symptoms.

These medicines act slowly. You may start to feel better within a few days of your first dose but for some people it may take several months to feel a benefit.

Most people will be treated with adalimumab for at least 1 year.

Adalimumab may be stopped if you have significant side effects, or if you have not responded well when reviewed after 12 to 16 weeks from starting the treatment.

Your treatment plan will be reviewed at least every 12 months.

Before you start the medicine

You need a few blood tests to make sure it's safe for you to start taking the medicine. These may include tests to check:

• your blood count
• tuberculosis (TB)
• liver and kidney function
• hepatitis B
• hepatitis C
• Epstein-Barr virus, which causes glandular fever
• HIV
• chickenpox

It is important to let a member of the IBD team know if you:

• have a history of cancer
• have heart problems
• have a history of recurrent infections
• are pregnant, planning to become pregnant or are currently breastfeeding
• have ever had a disease that affects the nervous system, including any symptoms of numbness, tingling or vision problems

Regular blood tests

When you first start adalimumab, you need to have regular blood tests every 3 months.

Once your condition is stable you may need fewer blood tests, for example every 6 months.

Having these blood tests are essential. If these are not done your prescription may be withheld until you have your blood test.

You need to arrange your own blood tests. They can be done at our hospitals or arranged by your GP.

For blood tests at our hospitals, request a blood test form by emailing [email protected]

For blood tests arranged by your GP, they will issue the blood test form. The tests you need are FBC, U&Es, LFT, and CRP.

It is your responsibility to make sure you arrange your blood tests when needed and that all results are sent to the IBD nursing team by emailing [email protected].

Repeat prescriptions

Prescriptions are organised through your IBD team at Guy’s and St Thomas’ but all supplies are delivered through a homecare company. The homecare company:

• delivers your medicine
• trains you how to give the injections
• provides you with a yellow sharps bin to dispose of used pens and syringes

Make sure your contact details are up to date at the hospital, as these are used to arrange deliveries.

If your medicine is delivered through Healthcare at Home (HaH), call their customer service on 0333 103 9699 or email [email protected] (Monday to Friday, 8am to 8pm or until 4.30pm on weekends and bank holidays).

If your medicine is delivered through Calea home care company, call their customer service on 0800 121 8300 or use the contact form on their website.

To continue receiving your medicine, please make sure you have your regular blood tests.

Useful information

Crohn's and Colitis UK has more information about IBD.