Hadlima (Adalimumab-Bwwd) for Psoriasis and Psoriatic Arthritis

Hadlima (adalimumab-bwwd) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with moderate to severe chronic plaque psoriasis and active psoriatic arthritis.

How Hadlima Works and How It’s Taken

Hadlima is a type of medication called a tumor necrosis factor (TNF) blocker. It works by binding to TNF-alpha, a protein involved in inflammation. By blocking TNF-alpha, Hadlima helps reduce inflammation.

In people with plaque psoriasis, treatment may reduce skin thickening and the buildup of inflammatory cells in the skin.

Hadlima is a biosimilar of Humira (adalimumab). This means it is made from living cells and is designed to work like the original medicine. The FDA requires biosimilars to have no meaningful differences in safety or how well they work.

Doctors prescribe Hadlima when adults with moderate to severe chronic plaque psoriasis may need treatment that works throughout the body or light therapy, and when other treatments are less appropriate.

Hadlima is given as an injection under the skin. With proper training and a doctor’s guidance, people or caregivers may give the injections at home.

Typical Dosing for Psoriasis

The recommended starting dose of Hadlima for psoriasis is 80 milligrams as an initial dose.

One week later, treatment continues with 40 milligrams every other week.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Hadlima Side Effects

In clinical studies of Hadlima for moderate to severe chronic plaque psoriasis in adults, the most common side effects occurred in at least 10 percent of people. These side effects were:

Infections, such as upper respiratory infections and sinus infections
Injection site reactions, such as redness or skin discoloration, itching, bleeding, pain, or swelling where the shot is given
Headache
Rash

Serious Side Effects and Warnings

Hadlima can cause serious side effects that may require immediate medical attention. These include:

Serious infections — Severe infections can occur, including tuberculosis (TB) and invasive fungal infections, because Hadlima affects the immune system.
Malignancies — Cancers, including lymphoma and other cancers, can occur.
Hypersensitivity reactions — Severe allergic reactions such as anaphylaxis or angioedema can cause swelling and trouble breathing.
Hepatitis B virus (HBV) reactivation — The virus can become active again in people who carry it.
Nervous system problems — Rare demyelinating disorders, which affect the protective covering of nerves, can occur, such as optic neuritis or Guillain-Barré syndrome.
Blood problems — Rare but serious low blood cell counts can lead to easy bruising, bleeding, or persistent fever.
New or worsening heart failure — The heart may not pump as well, leading to symptoms like shortness of breath or swelling.
Immune system reactions — These can include lupus-like syndrome or autoimmune hepatitis, where the immune system attacks the body.

Get medical help right away if you think you are having a serious reaction.

How To Save on Hadlima

The Hadlima For You program offers support and savings resources. Eligible people with commercial insurance may pay as little as $0.

The Hadlima For You program also offers dedicated Nurse Coaches, injection support, additional educational resources, and copay assistance. To learn more, visit the Hadlima For You page or call 833-442-3546.

What To Know Before Taking Hadlima

Before starting Hadlima, your doctor will check you for active TB and test for latent (hidden) TB. If you are at risk for HBV infection, your doctor may evaluate you for prior HBV infection before treatment.

If possible, people should be up to date on recommended vaccines before starting Hadlima. Do not receive live vaccines while using Hadlima.

Tell your doctor if you have any allergies to adalimumab or any ingredients in Hadlima.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Tell your doctor if you:

Have an infection or get infections that keep coming back
Have been exposed to TB or have risk factors for TB
Have had hepatitis B
Have a history of certain nerve problems, such as multiple sclerosis
Live in or have traveled to areas where fungal infections, such as histoplasmosis, coccidioidomycosis, or blastomycosis, are common
Have heart failure
Have a history of cancer
Use medicines such as Orencia (abatacept), Kineret (anakinra), Rituxan (rituximab), Imuran (azathioprine), or Purinethol (6-mercaptopurine, 6-MP)
Are scheduled to have major surgery

Do not start Hadlima if you have an active infection.

Hadlima is also FDA-approved to treat Crohn’s disease, ulcerative colitis, rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, hidradenitis suppurativa, and noninfectious intermediate, posterior, and panuveitis.

If you miss a dose, take it as soon as you can. Then return to your regular dosing schedule.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Hadlima, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Hadlima for psoriasis?

In a study of adults with plaque psoriasis, 71 percent of people treated with adalimumab reached PASI 75 at week 16, compared with 7 percent of people who took placebo (an inactive treatment). PASI 75 means at least a 75 percent improvement in psoriasis severity.

Also at week 16, 62 percent of people treated with adalimumab were rated clear or minimal, compared with 4 percent of people taking placebo.

How effective is Hadlima for psoriatic arthritis?

In a clinical study of adults with psoriatic arthritis, 57 percent of people treated with adalimumab achieved an ACR20 response at 24 weeks, compared with 15 percent of people who received placebo.

At 24 weeks, 39 percent of people treated with adalimumab achieved an ACR50 response, and 23 percent achieved an ACR70 response, compared with 6 percent and 1 percent of people who received placebo.

Among participants whose psoriasis affected at least 3 percent of their body surface area, 59 percent achieved PASI 75 and 42 percent achieved PASI 90 at 24 weeks, compared with 1 percent and 0 percent of people who received placebo. PASI 75 and PASI 90 indicate at least 75 percent and 90 percent improvement in psoriasis severity.

Should I take Hadlima for psoriasis or psoriatic arthritis if I have an infection?

Hadlima should not be started if you have an active infection, including a localized infection. This medicine can lower your immune system’s ability to fight infections and can raise the risk of serious infections, including tuberculosis, fungal infections, and other bacterial or viral infections.

Contact your doctor if you develop signs or symptoms of infection during treatment.