Drug/Small Molecule:
adalimumab

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB gathers information regarding PGx on FDA drug labels from the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels", and from FDA-approved FDA and EMA-approved (European Medicines Agency) EMA labels brought to our attention. Excerpts from the label and downloadable highlighted label PDFs are manually curated by PharmGKB.

Please note that some drugs may have been removed from or added to the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels" without our knowledge. We periodically check the table for additions to this table and update PharmGKB accordingly.

There is currently no such list for European drug labels - we are working with the EMA to establish a list of European Public Assessment Reports (EPAR)s that contain PGx information. We are constructing this list by initially searching for drugs for which we have PGx-containing FDA drug labels - of these 44 EMA EPARs were identified and are being curated for pgx information.

We welcome any information regarding drug labels containing PGx information approved by the FDA, EMA or other Medicine Agencies around the world - please contact feedback.



PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No Clinical Annotations available VA
rs1043879 12250169T>C, 25570081T>C, 716A>G, Glu239Gly
T > C
Missense
Glu239Gly
No VIP available No Clinical Annotations available VA
rs10499194 138002637C>T, 42172094C>T
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs10903129 12449025A>G, 25768937A>G, 81-4316A>G
A > G
Intronic
No VIP available CA VA
rs10919563 1382-304G>A, 1865-304G>A, 198700442G>A, 50189084G>A, 97218G>A
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs11586238 117263138C>G, 87235056C>G
C > G
Not Available
No VIP available No Clinical Annotations available VA
rs13031237 395-7883G>T, 39958016G>T, 61136129G>T
G > T
Intronic
No VIP available CA No Variant Annotations available
rs1799724 *1012C>T, -1037C>T, 2828023C>T, 2836120C>T, 2873283C>T, 2885366C>T, 2922188C>T, 3052098C>T, 31482482C>T, 31542482C>T, 4133C>T, 7607C>T, TNF:-850C-T, TNF:-857 C/T
C > T
5' Flanking
No VIP available No Clinical Annotations available VA
rs1800471 14127094C>G, 16203G>C, 41858876C>G, 5956G>C, 74G>C, Arg25Pro, TGFB1:914G>C, TGFB1:Arg25Pro, TGFB1:Ex1-282G>C, TGFB1:G915C, TGFB1:GC915
C > G
Missense
Arg25Pro
No VIP available CA VA
rs1800629 -308, -308G>A, -488G>A, 2828572G>A, 2836669G>A, 2873832G>A, 2885915G>A, 2922737G>A, 3052647A>A, 31483031G>A, 31543031G>A, 4682G>A, 8156G>A, TNF alpha -308G/A, TNF2, TNF:, TNF:-308 G/A, TNF:-308G/A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs1800795 -237C>G, 22756645C>G, 22766645C>G, 4880C>G, 50-321G>C
C > G
Intronic
No VIP available No Clinical Annotations available VA
rs1801274 12968387A>G, 161479745A>G, 497A>G, 500A>G, 9541A>G, FCGR2A:His131Arg
A > G
Missense
His167Arg
No VIP available No Clinical Annotations available VA
rs1980422 204610396C>T, 54819814C>T
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs20575 10917470C>G, 23059324C>G, 28357G>C, 626G>C, Arg209Thr
C > G
Missense
Arg209Thr
No VIP available No Clinical Annotations available VA
rs2104286 10228A>G, 6039045T>C, 6099045T>C, 64+5006A>G
T > C
Intronic
No VIP available No Clinical Annotations available VA
rs2228145 1066+4514A>C, 1066+4514A>T, 1073A>C, 1073A>T, 154426970A>C, 154426970A>T, 54302A>C, 54302A>T, 5915612A>C, 5915612A>T, Asp358Ala, Asp358Val
A > T
A > C
Intronic
Asp358Ala
No VIP available No Clinical Annotations available VA
rs2476601 114377568A>A, 114377568A>G, 1693C>C, 1693C>T, 1858C>C, 1858C>T, 41808C>C, 41808C>T, 84349486A>A, 84349486A>G, Arg565=, Arg620=
A > G
Missense
Arg620Trp
No VIP available No Clinical Annotations available VA
rs2736340 11343973C>T, 3819324C>T
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs2812378 -197C>T, 34700260G>A, 34710260G>A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs3087243 *1384G>A, *1421G>A, 11411G>A, 204738919G>A, 54948337G>A
G > A
3' Flanking
No VIP available No Clinical Annotations available VA
rs3218253 -34+1055C>T, 16935379G>A, 37544810G>A
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs3761847 -1638C>T, -366+1153C>T, 123690239G>A, 52854771G>A, 6213C>T
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs3794271 13620217G>A, 20860093G>A, 404+1078G>A, 50+1078G>A
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs394581 159482521C>T, 63651978C>T
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs396991 10872T>G, 13003184A>C, 158V/F, 161514542A>C, 176F/V, 523T>G, 526T>G, 631T>G, 634T>G, A559C, FCGR3A: V158F, Phe175Val, Phe176Val, Phe211Val, Phe212Val, T559G
A > C
Missense
Phe175Val
No VIP available No Clinical Annotations available VA
rs4750316 6333260C>G, 6393260C>G, 978C>G
C > G
3' Flanking
No VIP available No Clinical Annotations available VA
rs4810485 14944039T>G, 44747947T>G, 51+914T>G, 6042T>G
T > G
Intronic
No VIP available No Clinical Annotations available VA
rs548234 106568034C>T, 10737491C>T
C > T
Not Available
No VIP available No Clinical Annotations available VA
rs6691117 118459A>G, 1300710A>G, 207782931A>G, 4843A>G, 6193A>G, Ile1615Val, Ile2065Val
A > G
Missense
Ile2065Val
No VIP available No Clinical Annotations available VA
rs6822844 123509421G>T, 48057142G>T
G > T
Not Available
No VIP available No Clinical Annotations available VA
rs6920220 138006504G>A, 42175961G>A
G > A
Not Available
No VIP available No Clinical Annotations available VA
rs7527798 1143-244T>C, 1390069T>C, 207872290T>C
T > C
Intronic
No VIP available No Clinical Annotations available VA
rs7574865 191964633T>G, 274-23582A>C, 42174051T>G, 56293A>C
T > G
Intronic
No VIP available CA VA
rs767455 36A>G, 5317A>G, 6390945T>C, 6450945T>C, Pro12=
T > C
Synonymous
Pro12Pro
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138

Overview

Generic Names
  • Ig gamma-1 chain C region
Trade Names
  • Humira
  • Humira (Abbott Laboratories)
  • Humira Pen
Brand Mixture Names

PharmGKB Accession Id:
PA10004

Description

Adalimumab is a human monoclonal antibody against TNF-alpha. It is produced by recombinant DNA technology using a mammalian cell expression system. It consists of 1330 amino acids and has a molecular weight of approximately 148 kilodaltons.

Source: Drug Bank

Indication

For treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and Crohn's disease.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Adalimumab binds to TNF-alpha and blocks its interaction with the p55 and p75 cell surface TNF receptors. Adalimumab also lyses surface TNF expressing cells in vitro in the presence of complement.

Source: Drug Bank

Pharmacology

Used in the treatment of immune system mediated diseases, adalimumab binds specifically to TNF-alpha and blocks its general cytokine effects, thereby reducing TNF-induced inflammation and halting tissue destruction.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Most likely removed by opsonization via the reticuloendothelial system.

Source: Drug Bank

Half-Life

10-20 days.

Source: Drug Bank

Clearance

Source: Drug Bank

Chemical Properties

Chemical Formula

C6428H9912N1694O1987S46

Source: Drug Bank

Canonical SMILES

Not Available

Source: Drug Bank

Average Molecular Weight

144190.3000

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
C1QA (source: Drug Bank)
C1QB (source: Drug Bank)
C1QC (source: Drug Bank)
C1R (source: Drug Bank)
C1S (source: Drug Bank)
FCGR1A (source: Drug Bank)
FCGR2A (source: Drug Bank)
FCGR2B (source: Drug Bank)
FCGR2C (source: Drug Bank)
FCGR3A (source: Drug Bank)
FCGR3B (source: Drug Bank)
TNF (source: Drug Bank)

Drug Interactions

Drug Description
adalimumab Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to adalimumab: 26

No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Confirmation of -174G/C interleukin-6 gene promoter polymorphism as a genetic marker predicting antitumor necrosis factor treatment outcome. Pharmacogenetics and genomics. 2013. Dávila-Fajardo Cristina L, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Association of TNF-alpha polymorphism with prediction of response to TNF blockers in spondyloarthritis and inflammatory bowel disease: a meta-analysis. Pharmacogenomics. 2013. Tong Qiang, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
The role of Fcgamma receptor polymorphisms in the response to anti-tumor necrosis factor therapy in psoriasis A pharmacogenetic study. JAMA dermatology (Chicago, Ill.). 2013. Julià Marc, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Association of a complement receptor 1 gene variant with baseline erythrocyte sedimentation rate levels in patients starting anti-TNF therapy in a UK rheumatoid arthritis cohort: results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate cohort. The pharmacogenomics journal. 2013. Bluett J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Association between tumor necrosis factor-alpha (TNF-alpha) promoter -308 G/A and response to TNF-alpha blockers in rheumatoid arthritis: a meta-analysis. Modern rheumatology / the Japan Rheumatism Association. 2013. Zeng Zhen, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
GWAS replication study confirms the association of PDE3A-SLCO1C1 with anti-TNF therapy response in rheumatoid arthritis. Pharmacogenomics. 2013. Acosta-Colman Isabel, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Biologic therapies in the treatment of psoriasis: a comprehensive evidence-based basic science and clinical review and a practical guide to tuberculosis monitoring. Clinical reviews in allergy & immunology. 2013. Sivamani Raja K, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Genome-Wide Association Study and Gene Expression Analysis Identifies CD84 as a Predictor of Response to Etanercept Therapy in Rheumatoid Arthritis. PLoS genetics. 2013. Cui Jing, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of disease-modifying antirheumatic drugs in rheumatoid arthritis: towards personalized medicine. Pharmacogenomics. 2013. Umićević Mirkov Maša, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Gene polymorphisms that can predict response to anti-TNF therapy in patients with psoriasis and related autoimmune diseases. The pharmacogenomics journal. 2013. Prieto-Pérez R, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Effects of polymorphisms in TRAILR1 and TNFR1A on the response to anti-TNF therapies in patients with rheumatoid and psoriatic arthritis. Joint, bone, spine : revue du rhumatisme. 2012. Morales-Lara María José, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
TGF beta1 polymorphisms are candidate predictors of the clinical response to rituximab in rheumatoid arthritis. Joint, bone, spine : revue du rhumatisme. 2012. Daïen Claire Immediato, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Association of Rheumatoid Arthritis Risk Alleles with Response to Anti-TNF Biologics: Results from the CORRONA Registry and Meta-analysis. Inflammation. 2012. Pappas Dimitrios A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Genetic and genomic predictors of anti-TNF response. Pharmacogenomics. 2011. Prajapati Rita, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Rheumatoid arthritis risk allele PTPRC is also associated with response to anti-tumor necrosis factor alpha therapy. Arthritis and rheumatism. 2010. Cui Jing, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
CD11c as a transcriptional biomarker to predict response to anti-TNF monotherapy with adalimumab in patients with rheumatoid arthritis. Clinical pharmacology and therapeutics. 2010. Stuhlmüller B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Genotype at the sIL-6R A358C polymorphism does not influence response to anti-TNF therapy in patients with rheumatoid arthritis. Rheumatology (Oxford, England). 2010. Hassan Batool, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The TNF superfamily in 2009: new pathways, new indications, and new drugs. Drug discovery today. 2009. Tansey Malú G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Normalization of A2A and A3 adenosine receptor up-regulation in rheumatoid arthritis patients by treatment with anti-tumor necrosis factor alpha but not methotrexate. Arthritis and rheumatism. 2009. Varani Katia, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Criteria for the selection of single nucleotide polymorphisms in pathway pharmacogenetics: TNF inhibitors as a case study. Drug discovery today. 2009. Kooloos Wouter M, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
TNF-alpha-308 G/A polymorphism and responsiveness to TNF-alpha blockade therapy in moderate to severe rheumatoid arthritis: a systematic review and meta-analysis. The pharmacogenomics journal. 2009. O'Rielly D D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics of anti-TNF treatment in patients with rheumatoid arthritis. Pharmacogenomics. 2007. Coenen Marieke J H, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Potential role of pharmacogenetics in anti-TNF treatment of rheumatoid arthritis and Crohn's disease. Drug discovery today. 2007. Kooloos Wouter M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
The -308 tumour necrosis factor-alpha gene polymorphism predicts therapeutic response to TNFalpha-blockers in rheumatoid arthritis and spondyloarthritis patients. Rheumatology (Oxford, England). 2007. Seitz M, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Association of TNF-alpha -308 G/A polymorphism with responsiveness to TNF-alpha-blockers in rheumatoid arthritis: a meta-analysis. Rheumatology international. 2006. Lee Young Ho, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Tumour necrosis factor (TNF)alpha -308 G/G promoter polymorphism and TNFalpha levels correlate with a better response to adalimumab in patients with rheumatoid arthritis. Scandinavian journal of rheumatology. 2006. Cuchacovich M, et al. PubMed

LinkOuts

GenBank:
J00228
Web Resource:
Wikipedia
UniProtKB:
P01857
National Drug Code Directory:
0074-3799-02
DrugBank:
DB00051
Drugs Product Database (DPD):
2258595
Therapeutic Targets Database:
DAP000392
FDA Drug Label at DailyMed:
608d4f0d-b19f-46d3-749a-7159aa5f933d

Clinical Trials

These are trials that mention adalimumab and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.