Please ensure Medicare assignment is signed by patient, otherwise patient may receive an invoice.

Please note: Medicare Rebate for this test is subject to conditions. Patients may receive an invoice. Out of Pocket cost - $50.00 for both level or antibodies.

 Note: Patients with a negative ADL level (<= 0.4 ug/ml) will be tested for anti-ADL antibodies.

Adalimumab (ADL) levels of 5 µg/ml have been suggested as a cut-off for likelihood of clinical remission in IBD. If the patient has an ADL level of >5ug/ml with active disease, this suggests ADL drug resistance. If ADL levels are <5ug/ml with positive anti-ADL antibodies, suggest therapy be changed. Adalimumab levels Patients with a negative ADL level (<= 0.4 ug/ml) will be tested for Anti-ADL antibodies.

In the setting of active IBD:

• Adalimumab level = subtherapeutic AND
• Anti-Adalimumab Antibodies = low or negative

Action: Increase dose and/or decrease interval. Consider adding a thiopurine or methotrexate (if patient is not taking either agent).

• Adalimumab level = subtherapeutic and
• Anti-Adalimumab Antibodies = High

Action: Switch within class (anti-TNF). Consider adding a thiopurine or methotrexate.

• Adalimumab level: Therapeutic but not responding
• (Anti-Adalimumab Antibodiesnot required)

Action: Switch to vedolizumab with or without immunomodulator.

Ref: Am J Gastroenterol Suppl 2016; 3: 8-16

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This test can be added up to 7 days from collection, if refrigerated.