TNF inhibitors such as Adalimumab are used when first-line medicines like methotrexate, leflunomide, or sulfasalazine do not adequately control disease.
They are effective in treating rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis by reducing inflammation and preventing further joint and tissue damage.
In arthritis, the body’s own immune cells start to attack the joints, causing swelling, pain, and stiffness.
TNF inhibitors stop this process, helping reduce pain, swelling, and stiffness while protecting the joints from further damage.
In Sri Lanka, Adalimumab is usually given as an injection once every two weeks.
Once good disease control is achieved, the dose may be extended (e.g. once every 3 weeks, once a month, or even up to once in 3 months depending on symptoms, blood tests and your doctor’s judgement ).
This helps to reduce cost while maintaining control.
Before starting TNF inhibitors, your doctor will arrange:
Many patients notice improvement in 2–6 weeks, but full benefits may take 3 months.
Continue treatment regularly, even if symptoms improve early.
Because TNF inhibitors lower the immune response, there is a rare risk of infections.
If you develop fever, cough, chest pain, or breathlessness, stop the medicine and contact your doctor immediately.
Vaccinations: Always inform your physician before receiving any vaccine. Live vaccines are usually not recommended while on treatment.
Regular blood tests, chest X-rays, and follow-up reviews will be scheduled to check safety and monitor disease activity.
Without monitoring, you may risk drug side effects or disease flares that can lead to permanent joint damage.
Your rheumatologist will ensure safe use with regular monitoring.
Because Adalimumab is costly, it is often used in combination with:
This helps reduce the cost by allowing more sparing use of Adalimumab.
For more details, see the Australian Rheumatology Association (ARA) patient leaflet on TNF Inhibitors:
