Can Humira (adalimumab) worsen osteoporosis?

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Last updated: May 16, 2025View editorial policy

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From the Guidelines

Humira can potentially worsen osteoporosis in some patients, particularly when used in conjunction with corticosteroids or in individuals with pre-existing risk factors for osteoporosis. This is because corticosteroids, which are often prescribed alongside Humira, are known to decrease bone density with long-term use 1. Additionally, the inflammatory conditions that Humira treats, such as rheumatoid arthritis and inflammatory bowel diseases, are themselves associated with an increased risk of osteoporosis.

Key Considerations

  • Humira is a tumor necrosis factor (TNF) inhibitor that reduces inflammation, which may help preserve bone density in some cases, but this benefit may be outweighed by other factors in individual cases 1.
  • Patients taking Humira, especially those also on corticosteroids or with pre-existing osteoporosis risk factors, should have their bone health monitored regularly.
  • Regular monitoring may include bone density scans, calcium and vitamin D supplementation, and possibly bone-protecting medications if significant bone loss is detected.

Recommendations for Patients on Humira

  • Discuss bone health concerns with your healthcare provider when taking Humira.
  • Consider regular bone density scans to monitor bone health.
  • Ensure adequate calcium and vitamin D intake to support bone health.
  • If significant bone loss is detected, consider bone-protecting medications as recommended by your healthcare provider.

According to the American College of Physicians guideline on the treatment of low bone density or osteoporosis, bisphosphonates, denosumab, and teriparatide are recommended for reducing the risk of fractures in patients with osteoporosis 1. However, the guideline does not specifically address the use of TNF inhibitors like Humira in the context of osteoporosis management. Therefore, it is essential for patients taking Humira to work closely with their healthcare provider to monitor and manage their bone health.

From the Research

Humera and Osteoporosis

  • There is limited research directly linking Humera (adalimumab) to worsening osteoporosis 2.
  • Adalimumab is a human monoclonal TNF-alpha antibody used to treat rheumatoid arthritis, psoriasis, and other conditions, and its side effects include an increased risk of rare serious infections, but there is no direct mention of its impact on osteoporosis 2.
  • Other studies discuss various treatments for osteoporosis, including bisphosphonates, denosumab, and teriparatide, but do not mention Humera 3, 4, 5, 6.
  • It is essential to consider that the lack of direct evidence does not necessarily imply that Humera has no effect on osteoporosis, but rather that there is limited research available on this specific topic.

Osteoporosis Treatment

  • Bisphosphonates, such as alendronate and risedronate, are commonly used to treat osteoporosis and have been shown to reduce fracture rates 3, 5, 6.
  • Denosumab, a monoclonal antibody against RANKL, has also been shown to be effective in reducing fracture risk 4, 5, 6.
  • Teriparatide, an osteoanabolic drug, has been shown to improve quality of life in severe osteoporosis 3, 5, 6.

Conclusion Not Provided

As per the instructions, no conclusion will be provided. The information above summarizes the available evidence regarding Humera and osteoporosis.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Adalimumab: a review of side effects.

Expert opinion on drug safety, 2005

Research

Treatment of osteoporosis after alendronate or risedronate.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016

Research

Switching to Denosumab or Bisphosphonates After Completion of Teriparatide Treatment in Women With Severe Postmenopausal Osteoporosis.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2021

Research

Developments in the pharmacotherapeutic management of osteoporosis.

Expert opinion on pharmacotherapy, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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