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Humira (adalimumab) is a biologic medication used to treat several inflammatory conditions, including rheumatoid arthritis, Crohn's disease, and plaque psoriasis. It is also used to treat various autoimmune disorders, such as psoriasis, arthritis, and ulcerative colitis. While Humira can provide significant benefits for people with these conditions, it is not without its side effects. Some people taking Humira have reported muscle-related symptoms, including back pain and muscle cramps. In rare cases, Humira can disrupt cytokine balance, leading to muscle pain and other issues. This paragraph introduces the topic of Humira's potential side effects, with a specific focus on muscle pain, and provides context by explaining what Humira is used for.
| Characteristics | Values |
|---|---|
| Muscle pain | Back pain (6% of patients), muscle cramps (less than 5% of patients), muscle weakness, muscle aches |
| Muscle-related symptoms | Caused by disruption of cytokine balance |
| Lupus-like syndrome | Joint pain, swelling, stiffness, butterfly-shaped rash on the face, rashes that worsen in the sun, fever, unusual weakness or fatigue |
| Other common side effects | Injection site reactions, headaches, skin rashes, infections, skin cancer, mood alterations (including depression), anxiety, insomnia, arthritis, bone disorder, bone fracture, bone necrosis, joint disorder, pelvic pain, weight gain |
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What You'll Learn
Muscle pain and lupus-like symptoms
Lupus affects different people in different ways. Most people with lupus experience problems with their joints, muscles, or bones. Lupus arthritis most often affects joints farther from the middle of the body, like fingers, wrists, elbows, knees, ankles, and toes. Lupus arthritis is less likely to cause permanent joint damage than rheumatoid arthritis.
Lupus can also cause joint pain (arthralgia) and inflammation around the joints, resulting in problems like arthritis, tendonitis, and carpal tunnel syndrome. Joint problems related to lupus usually do not cause long-term damage. Lupus arthritis makes joints hurt and feel stiff, tender, warm, and swollen.
Lupus can trigger pain in your tendons and bones as well. Tendinitis, which affects around 10% of lupus cases, causes pain and stiffness in your joints. It commonly occurs in fingers, elbows, rotator cuffs, and heels. Bursitis, or swelling in the bursae, is most likely to occur in the elbows, shoulders, and fingers. Carpal tunnel syndrome, which can be caused by inflammation, can put too much pressure on the central nerve in your wrist, causing pain and a numb or tingly feeling in your hands and fingers.
Lupus raises your risk for osteoporosis, a bone disease that makes bones weak and prone to breaking. Avascular necrosis (AVN) is less common but can be caused by taking high doses of steroids to treat lupus. AVN causes bone tissue to die due to a lack of blood flow, resulting in pressure buildup. The first signs of AVN are pain in the knees, hips, or shoulders, followed by stiff joints and muscle spasms.
In rare cases, Humira, a biologic medication used to treat autoimmune disorders, can cause muscle-related symptoms by disrupting cytokine balance. It can also trigger antinuclear antibodies (ANA), which may lead to drug-induced lupus, a condition that includes muscle pain. Back pain was reported in 6% of patients taking Humira, while muscle cramps were reported in less than 5%.
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Injection site reactions
- Itching
- Pain
- Swelling
- Redness
These reactions are usually mild and tend to resolve within a few hours. To minimise discomfort, it is recommended to bring the injection to room temperature before administering it and to numb the skin with a cold compress beforehand. Injection sites should be rotated, and the injection can be administered into the thigh instead of the stomach.
In rare cases, injection site reactions may indicate a more serious issue. For example, they could be a sign of psoriasis, a skin condition that Humira is approved to treat. If you experience persistent or severe injection site reactions, it is important to consult your healthcare provider for guidance and to rule out any underlying conditions.
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Skin rashes
Rashes can manifest as redness, irritation, itching, or swelling near the site of injection. They are more likely to occur during the first month of treatment. However, newer Humira products are citrate-free, which has helped limit irritation.
In some cases, Humira can cause new or worsening psoriasis, a skin condition that causes red scaly patches and raised bumps containing pus. If you experience a rash during Humira treatment, contact your doctor.
Other possible skin-related side effects include:
- Skin sores or wounds
- Skin lumps
- Changes to moles or freckles
- Severe itchiness
- Lupus-like syndrome, which can include a butterfly-shaped rash on the face and rashes that worsen in the sun
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Headaches
If your headache lasts longer than a week, gets worse, or is accompanied by other symptoms such as numbness or tingling, vision changes, muscle weakness, or unexplained dizziness, it is important to seek medical advice as these could be signs of nervous system problems or other underlying conditions.
It is important to carefully consider the risks and benefits of taking Humira, especially if you have a history of chronic or recurrent infections, as the medication can increase the risk of serious infections, including TB, fungal infections, and bacterial and viral infections.
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Serious infections
As Humira works by suppressing the immune system, patients are at an increased risk of developing serious infections that may lead to hospitalization or even death. Doctors carefully monitor patients for serious infections during treatment, and it is important to inform your doctor if you get symptoms of infection such as fever, fatigue, persistent cough, wounds, skin sores, dental problems, or burning during urination.
Infections that may develop during treatment include tuberculosis (TB), hepatitis B, and invasive fungal infections, such as histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with TB may present with disseminated or extrapulmonary disease, and those with histoplasmosis or other invasive fungal infections may present with disseminated disease rather than localized disease.
Other serious infections that may occur include sepsis, bacterial infections, viral infections, and those caused by opportunistic pathogens, including Legionella and Listeria. Patients taking Humira may also be at risk of developing sinus infections, lower respiratory tract infections, ear infections, and eye infections.
It is important to note that Humira can also cause new or worsening psoriasis, which presents as red scaly patches or raised pus-filled bumps on the skin.
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Frequently asked questions
Muscle pain is not listed as a common side effect of Humira. However, back pain was reported in 6% of patients, and muscle cramps were reported in less than 5% of patients. In rare cases, Humira can disrupt cytokine balance, leading to muscle-related symptoms.
The most common side effects of Humira are injection site reactions, headaches, skin rashes, and upper respiratory infections.
Serious side effects are uncommon, affecting less than 1% of people. These may include lupus-like symptoms, joint pain, chest pain, serious skin reactions, and allergic reactions.
If you experience any side effects from Humira, it is important to speak to your doctor or pharmacist. They can help you manage the side effects or discuss alternative treatment options. Do not stop taking Humira without consulting your doctor first.
