Adalimumab (Humira) in CKD

Sumida, K., Ubara, Y., Suwabe, T., Hayami, N., Hiramatsu, R., Hasegawa, E., Yamanouchi, M., Hoshino, J., Sawa, N. and Takaichi, K. (2013), Adalimumab treatment in patients with rheumatoid arthritis with renal insufficiency. Arthritis Care Res, 65: 471–475. doi: 10.1002/acr.21800

A small (65 total patients), retrospective analysis, looking for discontinuation or worsening renal function in patients with and without chronic kidney disease in rheumatoid arthritis patients starting adalimumab (Humira). In patients on dialysis, the Humira was given on non-dialysis days.

No differences were seen in discontinuation or worsening renal function. All discontinuations were due to lack of efficacy, rash, or interstitial pneumonia.

The authors suggest that adalimumab (Humira) could be used safely in patients with CKD but suggest monitoring closely for infections as decreased renal function is related to poor host immunity.