Adalimumab has linear pharmacokinetic properties throughout the clinical dose range. In healthy adults, the absolute bioavailability of adalimumab following a single 40-mg subcutaneous (s.c.) dose is 64%, and maximum plasma concentrations (4.7±1.6 ^g/ml) are achieved at 131±56 h. Concentrations of adalimumab in the synovial fluid from RA patients range from 31 % to 96% of those in serum (Abbott Laboratories 2006). Adalimumab 40 mg s.c. every other week (e.o.w.) produces steady-state serum trough concentrations of 4-8 ^g/ml, which are 3-7 times higher than the effective concentration (0.8-1.4 ^g/ml) in 50% of RA patients (Granneman et al. 2003). Concomitant MTX treatment does not significantly alter adalimumab pharmacokinetics. The presence of MTX does not adversely affect adalimumab serum concentrations. At the recommended dose of 40 mg e.o.w., mean steady-state serum concentrations are 5 ^g/ml without MTX and 8-9 ^g/ml with MTX. MTX reduced adalimumab apparent clearance after single and multiple dosing by 29% and 44%, respectively. Pharmacokinetic studies have not been conducted in children or in patients with hepatic or renal impairment (Abbott Laboratories 2006).
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