Humira(Cf) (adalimumab)
Antipsoriatics Subcutaneous Syringe Kit (Ea)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Adalimumab, adalimumab-aacf, adalimumab-aaty, adalimumab-adaz, adalimumab-adbm, adalimumab-afzb, adalimumab-aqvh, adalimumab-atto, adalimumab-bwwd, adalimumab-fkjp, and adalimumab-ryvk, recombinant DNA-derived human immunoglobulin G1 (IgG1) monoclonal antibodies, are tumor necrosis factor (TNF) inhibitors that are biologic disease-modifying antirheumatic drugs (DMARDs).
Adalimumab-aacf (Idacio(R)), adalimumab-aaty (Yuflyma(R)), adalimumab-adaz (Hyrimoz(R)), adalimumab-adbm (Cyltezo(R)), adalimumab-afzb (Abrilada(R)), adalimumab-aqvh (Yusimry(R)), adalimumab-atto (Amjevita(R)), adalimumab-bwwd (Hadlima(R)), adalimumab-fkjp (Hulio(R)), and adalimumab-ryvk (Simlandi(R)) are biosimilar to adalimumab (Humira(R)). FDA defines a biosimilar as a biological product that is highly similar to an FDA-licensed reference biological with the exception of minor differences in clinically inactive components and for which there are no clinically meaningful differences in safety, purity, or potency. The claim of biosimilarity is based on a totality-of-evidence approach, which includes consideration of data from analytical, animal, and clinical studies (e.g., human pharmacokinetic and pharmacodynamic studies, clinical immunogenicity assessment, additional comparative clinical studies).
Therefore, biosimilarity may be established even when there are formulation or minor structural differences as long as these differences are not clinically meaningful. Biosimilars are approved through an abbreviated licensure pathway that establishes biosimilarity between the proposed biological and the reference biological but does not independently establish safety and effectiveness of the proposed biological. In order to be considered an interchangeable biosimilar, a biological product must meet additional requirements beyond demonstrating biosimilarity to its reference product; these requirements include demonstrating that the biological product can be expected to produce the same clinical results as the reference product in any given patient and, for a biological product that is administered more than once to an individual, the risk in terms of safety or diminished efficacy of alternating or switching between use of the biological product and the reference product is no greater than the risk of using the reference product without such alteration or switch.
Biosimilar products that are interchangeable can be substituted for the reference product without the intervention of the healthcare provider who prescribed the reference product. Of the available adalimumab biosimilars, adalimumab-aaty (Yuflyma(R)), adalimumab-afzb (Abrilada(R)), adalimumab-atto (Amjevita(R)), adalimumab-adbm (Cyltezo(R)), adalimumab-bwwd (Hadlima(R)), adalimumab-adaz (Hyrimoz(R)), adalimumab-fkjp (Hulio(R)) and adalimumab-ryvk (Simlandi(R)) are designated as interchangeable with adalimumab (Humira(R)).
In this monograph, unless otherwise stated, the term ''adalimumab products'' refers to adalimumab (the reference drug) and its biosimilars (adalimumab-aacf, adalimumab-aaty, adalimumab-adaz, adalimumab-adbm, adalimumab-afzb, adalimumab-aqvh, adalimumab-atto, adalimumab-bwwd, adalimumab-fkjp, and adalimumab-ryvk).
Adalimumab, a human monoclonal antibody specific for human tumor necrosis factor (TNF; TNF-alpha), is a biologic response modifier. Adalimumab is produced by recombinant DNA technology in a mammalian cell expression system and is purified by a process that includes specific viral inactivation and removal steps.
Adalimumab has high specificity and affinity for TNF (TNF-alpha); adalimumab does not bind to or inactivate lymphotoxin alpha (TNF-beta). Adalimumab binds to TNF before TNF can interact with the p55 and p75 cell surface tumor necrosis factor receptors (TNFRs). By preventing the binding of TNF to cell surface TNFRs, adalimumab blocks the biologic activity of TNF.
In vitro, adalimumab lyses surface TNF-expressing cells in the presence of complement.
TNF, a naturally occurring cytokine, has a broad spectrum of biologic activities; TNF is involved in normal inflammatory and immune responses and also plays a role in a number of autoimmune and inflammatory diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, and ankylosing spondylitis. While the causes of rheumatoid arthritis have not been fully elucidated, increased concentrations of TNF in the synovial fluid of rheumatoid arthritis patients play a critical role in the progression of inflammatory synovitis and articular matrix degradation in these patients. TNF promotes the synthesis of other proinflammatory cytokines, stimulates endothelial cells to express adhesion molecules that attract leukocytes into affected joints, accelerates the production of metalloproteinases, and inhibits the synthesis of cartilage proteoglycans.
Increased concentrations of TNF also are found in psoriatic plaques. Adalimumab treatment may reduce epidermal thickness and infiltration of inflammatory cells in plaque psoriasis. Elevated levels of proinflammatory cytokines, including TNF, also have been observed in hidradenitis suppurativa lesions and in aqueous humor in patients with noninfectious uveitis.
Adalimumab modulates responses that are induced or regulated by TNF, including expression of adhesion molecules, serum concentrations of matrix metalloproteinase, and serum concentrations of cytokines.
The bioavailability of subcutaneous adalimumab is approximately 64%, with peak serum concentrations achieved at 131 hours. Adalimumab has been detected in synovial fluid. The elimination route for adalimumab has not been determined.
The half-life of adalimumab is approximately 2 weeks, but may range from 10-20 days. Clearance of adalimumab is increased among patients with adalimumab antibodies and decreased among patients over 40 years of age.
Several adalimumab biosimilars are available. Biosimilarity of these products has been demonstrated for the indications described in Table 1. Biosimilarity to originator adalimumab is additionally supported by comparative clinical studies in patients with rheumatoid arthritis (adalimumab-aacf, adalimumab-aaty, adalimumab-adaz, adalimumab-adbm, adalimumab-afzb, adalimumab-atto, adalimumab-bwwd, adalimumab-fkjp), Crohn disease (adalimumab-adbm), and/or psoriasis (adalimumab-aacf, adalimumab-adaz, adalimumab-adbm, adalimumab-aqvh, adalimumab-atto, adalimumab-ryvk).
Generic name: adalimumab
Pronunciation: (AY-da-LIM-ue-mab)
Drug class: Antipsoriatics
Therapeutic class: Analgesic, Anti-inflammatory or Antipyretic
Reference product & biosimilars
| Name | Biosimilar | Interchangeable |
|---|---|---|
|
Humira(Cf)
Reference
Cordavis Limite
|
||
| Celltrion Usa, | Biosimilar | Interchangeable |
| Celltrion Usa, | Biosimilar | Interchangeable |
| Boehringer Ingelheim | Biosimilar | Interchangeable |
| Quallent Pharma | Biosimilar | Interchangeable |
| Quallent Pharma | Biosimilar | Interchangeable |
| Boehringer Ingelheim | Biosimilar | Interchangeable |
| Teva Usa | Biosimilar | Interchangeable |
| Celltrion Usa, | Biosimilar | Interchangeable |
Today’s intelligence on Humira(Cf)
Indications
The following indications are listed for Humira(Cf):
- Ankylosing Spondylitis
- Crohn's Disease
- Hidradenitis Suppurativa
- Moderate To Severe Plaque Psoriasis
- Non-Infectious Uveitis
- Polyarticular Juvenile Idiopathic Arthritis
- Psoriatic Arthritis
- Rheumatoid Arthritis
- Ulcerative Colitis
Also known as: Acne Inversa, Arthritis Deformans, Arthrosis Deformans, Axial Spondyloarthritis With Radiographic Sacroiliitis, Bekhterev's Arthritis, Bekhterev's Disease, Bekhterev's Spondylitis, Colitis Ulcerativa, Marie-Strumpell Disease, Marie-Strumpell Spondylitis, Nodose Rheumatism, Noninfectious Uveitis, Polyarticular Jia, Polyarticular Jra, Polyarticular Juvenile Chronic Arthritis, Polyarticular Juvenile Rheumatoid Arthritis, Psoriasis Arthropica, Psoriatic Arthropathy, Regional Enteritis, Regional Ileocolitis, Rheumatic Arthritis, Rheumatic Gout, Rheumatoid Spondylitis, Rhizomelic Spondylitis, Rhizomelic Spondylosis, Spondylosis Deformans, Strumpell-Marie Disease, Suppurative Hidradenitis, Verneuil's Disease.
Dosing
No dosing information is available for this tab.
Adalimumab products are administered by subcutaneous injection. Adalimumab products are intended for use under the guidance and supervision of a clinician; however, the drug may be self-administered if the clinician determines that the patient and/or their caregiver is competent to safely administer the drug after appropriate training and with medical follow-up as necessary.
Adalimumab products are available in various formulations including single-dose prefilled syringes, prefilled pens, autoinjectors, and vials for institutional use only; please refer to the prescribing information of each individual product for further formulation information. Various packaging configurations (e.g., starter packs) may be available, depending on the specific product; contact the individual product manufacturer for more information. Some adalimumab products may not be available in presentations suitable for pediatric use, even if the product is labeled for pediatric use; consult the specific product information and manufacturer website for details.
Prior to administration, adalimumab product solutions should be inspected visually for particulate matter or discoloration; if either is present, the solution should be discarded. Adalimumab products contain no preservatives, and any unused portions of solution should be discarded. Adalimumab products should be stored at 2-8degreesC and protected from light; the prefilled syringes should be stored in the original carton until administration. The injection may be allowed to sit outside of refrigeration for 15-30 minutes prior to injection to allow the liquid to come to room temperature; the cap or cover should not be removed while the drug is warming to room temperature. The injection should not be frozen; solutions that have been frozen should not be used.
Storage requirements for the adalimumab products vary dependent upon the individual product and/or formulation; please refer to the prescribing information of each individual product for further information.
Subcutaneous injections of adalimumab products should be made into the anterior thighs or abdomen; however, abdominal injections should not be made within 5.18 cm (2 inches) of the umbilicus. Injection sites should be rotated. New injections should be given at least 2.54 cm (1 inch) from an old site, and injections should not be made into areas where the skin is tender, bruised, red, or hard, or into scars or stretch marks. Injections into psoriatic lesions also should be avoided.
| Drug label | Dosing type | Instructions |
|---|---|---|
| Cdv Humira(Cf) 40 Mg/0.4Ml Syr | Maintenance | Inject 0.4 milliliter (40 mg) by subcutaneous route every 2 weeks in the abdomen or thigh (rotate sites). |
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
Antibody-Based Therapies/Imlifidase
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Imlifidase is a cysteine protease that cleaves immunoglobulin G (IgG), which results in degradation of all subclasses of human and rabbit IgG. Therapies based on human or rabbit IgG may be inactivated if given concurrently with imlifidase.(1)
CLINICAL EFFECTS: Antibody therapies based on human or rabbit IgG may be inactivated and lead to decreased efficacy.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Concurrent use of imlifidase and antibody-based therapies should be closely evaluated for timing of administration to avoid decreased efficacy of the antibody-based therapy.(1) Antibody-based therapies cleaved by imlifidase include, but are not limited to, basiliximab, rituximab, alemtuzumab, adalimumab, denosumab, belatacept, etanercept, rabbit anti-human thymocyte globulin (rATG) and intravenous immunoglobulin (IVIg). The prescribing information recommends the following time intervals for administration of antibody-based therapies after administration of imlifidase: -Equine anti-thymocyte globulin: No time interval needed (may be administered concurrently) -Intravenous immunoglobulin (IVIg): 12 hours -Adalimumab, alemtuzumab, basiliximab, denosumab, etanercept, or rituximab: 4 days -Rabbit anti-human thymocyte globulin (rATG) or belatacept: 1 week In addition, IVIg may contain neutralizing antibodies against imlifidase, which may inactivate imlifidase if IVIg is given before imlifidase. Consider the half-life of IVIg (3-4 weeks) before imlifidase administration to patients treated with IVIg. Eculizumab is not cleaved by imlifidase at the recommended dose level.(1)
DISCUSSION: Imlifidase is a cysteine protease that cleaves IgG, which results in degradation of all subclasses of human and rabbit IgG. Antibody therapies based on human or rabbit IgG may be inactivated if given in connection with imlifidase.(1) IVIg may contain neutralizing antibodies against imlifidase, which may inactivate imlifidase if IVIg is given before imlifidase. In clinical studies, IVIg was not administered within 4 weeks before imlifidase infusion.(1)
Biologic Dmards/Sarilumab; Tocilizumab
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs may result in additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs may increase the risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of sarilumab(1) or tocilizumab(2) with other biologic DMARDs should be avoided.
DISCUSSION: Concurrent use of sarilumab(1) or tocilizumab(2) and other biologic DMARDs may increase the risk of infection.
Immunosuppressive; Immunomod/Cladribine Onc Inj (10 Mg/5 Ml)
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-2)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections.(1-2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The UK and AU manufacturers of Litak state that concomitant use of other myelosuppressive medicinal products with cladribine is contraindicated.(1-2) The Israeli manufacturer of Litak states that cladribine should not be used concomitantly with other myelosuppressive medicinal products.(3)
DISCUSSION: The risk of severe myelotoxicity and long-lasting immunosuppression is increased in patients with a disease-related bone marrow infiltration or a previous myelosuppressive treatment.(1-3)
Immunosuppressives; Immunomodulators/Efalizumab; Natalizumab
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Natalizumab,(1-3) efalizumab,(4) immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of natalizumab(1-3) or efalizumab(4) with immunosuppressives or immunomodulators may result in an increased risk of infections, including progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).
PREDISPOSING FACTORS: Previous JCV infection, longer duration of natalizumab treatment - especially if greater than 2 years, and prior or concomitant treatment with immunosuppressant medication are all independent risk factors which increase the risk for PML.(1,5) The FDA has estimated PML incidence stratified by risk factors: If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment less than 25 months, incidence <1/1,000. If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment less than 25 months, incidence 2/1,000 If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 4/1,000 If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 11/1,000.
PATIENT MANAGEMENT: The US manufacturer of natalizumab states patients with Crohn's disease should not receive concurrent immunosuppressants, with the exception of limited overlap of corticosteroids, due to the increased risk for PML. For new natalizumab patients currently receiving chronic oral corticosteroids for Crohn's Disease, begin corticosteroid taper when therapeutic response to natalizumab has occurred. If corticosteroids cannot be discontinued within six months of starting natalizumab, discontinue natalizumab.(3) The US manufacturer of natalizumab states that natalizumab should not ordinarily be used in multiple sclerosis patients receiving immunosuppressants or immunomodulators due to the increased risk for PML. Immunosuppressives include, but are not limited to azathioprine, cyclophosphamide, cyclosporine, mercaptopurine, methotrexate, mitoxantrone, mycophenolate, and corticosteroids.(3,6) The UK manufacturer of natalizumab states that concurrent use with immunosuppressives or antineoplastic agents is contraindicated.(1) The Canadian manufacturer of natalizumab states that natalizumab should not be used with immunosuppressive or immunomodulatory agents.(2) The US manufacturer of certolizumab states that concurrent therapy with natalizumab is not recommended.(7)
DISCUSSION: Progressive multifocal leukoencephalopathy has been reported in patients receiving concurrent natalizumab were recently or concomitantly taking immunomodulators or immunosuppressants.(1-5,8,9) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(10)
Selected Biologic Dmards/Abatacept
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Possibly additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of abatacept with anakinra, rituximab, or a tumor necrosis factor (TNF) blocking agent may increase the risk of severe infections without providing any clinical benefit.(1-5)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of abatacept states that abatacept should not be used with TNF blocking agents or other biologic DMARDs. Patients transitioning from TNF blocking agent therapy to abatacept should be closely monitored for signs of infection.(1) The US manufacturers of adalimumab,(2) certolizumab,(3) golimumab,(4) and infliximab(5) state that concurrent therapy with abatacept is not recommended.
DISCUSSION: In clinical trials, patients who received concurrent abatacept and TNF blocking agents experienced more infections (63% versus 43%) and more serious infections (4.4% versus 0.8%) than patients who received TNF agents alone. There was no significant additional efficacy over use of TNF agents alone.(1) In other trials, infections and serious infections were reported in 54% and 3%, respectively, of patients who received abatacept alone.(1)
Selected Immunosuppressants/Nadofaragene Firadenovec
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Nadofaragene firadenovec may contain low levels of replication-competent adenovirus.(1)
CLINICAL EFFECTS: Concurrent use of nadofaragene firadenovec in patients receiving immunosuppressive therapy may cause disseminated adenovirus infection.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Individuals who are immunosuppressed or immune-deficient should not receive nadofaragene firadenovec.(1)
DISCUSSION: Nadofaragene firadenovec is a non-replicating adenoviral vector-based gene therapy but may contain low levels of replication-competent adenovirus. Immunocompromised persons, including those receiving immunosuppressant therapy, may be at risk for disseminated adenovirus infection.(1)
Selected Immunosuppressants/Talimogene Laherparepvec
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Talimogene laherparepvec is a live, attenuated herpes simplex virus.(1)
CLINICAL EFFECTS: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Talimogene laherparepvec is contraindicated in immunosuppressed patients.(1) The magnitude of immunocompromise and associated risks due to immunosuppressant drugs should be determined by a physician.
DISCUSSION: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1)
Selected Immunosuppressive Agents/Live Vaccines; Live Bcg
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: A variety of disease modifying agents suppress the immune system. Immunocompromised patients may be at increased risk for uninhibited replication after administration of live, attenuated vaccines or intravesicular BCG. Immune response to vaccines may be decreased during periods of immunocompromise.(1)
CLINICAL EFFECTS: The expected serum antibody response may not be obtained and/or the vaccine may result in illness.(1) After instillation of intravesicular BCG, immunosuppression may interfere with local immune response, or increase the severity of mycobacterial infection following inadvertent systemic exposure.(2)
PREDISPOSING FACTORS: Immunosuppressive diseases (e.g. hematologic malignancies, HIV disease), treatments (e.g. radiation) and drugs may all increase the magnitude of immunodeficiency.
PATIENT MANAGEMENT: The Centers for Disease Control(CDC) Advisory Committee on Immunization Practices (ACIP) states that live-virus and live, attenuated vaccines should not be administered to patients who are immunocompromised. The magnitude of immunocompromise and associated risks should be determined by a physician.(1) For patients scheduled to receive chemotherapy, vaccination should ideally precede the initiation of chemotherapy by 14 days. Patients vaccinated while on immunosuppressive therapy or in the 2 weeks prior to starting therapy should be considered unimmunized and should be revaccinated at least 3 months after discontinuation of therapy.(1) Patients who receive anti-B cell therapies should not receive live vaccines for at least 6 months after such therapies due to a prolonged duration of immunosuppression. An exception is the Zoster vaccine, which can be given at least 1 month after receipt of anti-B cell therapies.(1) The US manufacturer of abatacept states live vaccines should not be given during or for up to 3 months after discontinuation of abatacept.(2) The US manufacturer of live BCG for intravesicular treatment of bladder cancer states use is contraindicated in immunosuppressed patients.(3) The US manufacturer of daclizumab states live vaccines are not recommended during and for up to 4 months after discontinuation of treatment.(4) The US manufacturer of guselkumab states that live vaccines should be avoided during treatment with guselkumab.(5) The US manufacturer of inebilizumab-cdon states that live vaccines are not recommended during treatment and after discontinuation until B-cell repletion. Administer all live vaccinations at least 4 weeks prior to initiation of inebilizumab-cdon.(6) The US manufacturer of ocrelizumab states that live vaccines are not recommended during treatment and until B-cell repletion occurs after discontinuation of therapy. Administer all live vaccines at least 4 weeks prior to initiation of ocrelizumab.(7) The US manufacturer of ozanimod states that live vaccines should be avoided during and for up to 3 months after discontinuation of ozanimod.(8) The US manufacturer of siponimod states that live vaccines are not recommended during treatment and for up to 4 weeks after discontinuation of treatment.(9) The US manufacturer of ustekinumab states BCG vaccines should not be given in the year prior to, during, or the year after ustekinumab therapy.(10) The US manufacturer of satralizumab-mwge states that live vaccines are not recommended during treatment and should be administered at least four weeks prior to initiation of satralizumab-mwge.(11) The US manufacturer of ublituximab-xiiy states that live vaccines are not recommended during treatment and until B-cell recovery. Live vaccines should be administered at least 4 weeks prior to initiation of ublituximab-xiiy.(12) The US manufacturer of etrasimod states that live vaccines should be avoided during and for 5 weeks after treatment. Live vaccines should be administered at least 4 weeks prior to initiation of etrasimod.(13) The US manufacturer of emapalumab-lzsg states that live vaccines should not be administered to patients receiving emapalumab-lzsg and for at least 4 weeks after the last dose of emapalumab-lzsg. The safety of immunization with live vaccines during or following emapalumab-lzsg therapy has not been studied.(14) The US manufacturer of sibeprenlimab-szsi states live vaccines should not be given within 30 days prior to initiation or during treatment with sibeprenlimab-szsi.(15)
DISCUSSION: Killed or inactivated vaccines do not pose a danger to immunocompromised patients.(1) Patients with a history of leukemia who are in remission and have not received chemotherapy for at least 3 months are not considered to be immunocompromised.(1)
Tumor Necrosis Factor (Tnf) Inhibitors/Vedolizumab
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Possibly additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of vedolizumab and a tumor necrosis factor (TNF) inhibitor may increase the risk of severe infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of vedolizumab states that concurrent use of vedolizumab with tumor necrosis factor (TNF) blocking agents should be avoided.(1)
DISCUSSION: Patients receiving or who had received a TNF inhibitor in the past 60 days were excluded from clinical trials for vedolizumab.(1)
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Biologic Therapies/Anifrolumab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of anifrolumab with other biologic therapies may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of anifrolumab with other biologic therapies may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of anifrolumab with other biologic therapies is not recommended.(1)
DISCUSSION: The combination of anifrolumab with other biologic therapies has not been studied and is not recommended.(1)
Igg Antibodies And Derivatives/Efgartigimod-Alfa
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Efgartigimod-alfa binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of efgartigimod-alfa states that efgartigimod-alfa should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, efgartigimod-alfa should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with efgartigimod-alfa have not been performed. Efgartigimod-alfa may decrease concentrations of compounds that bind to the human FcRn.(3)
Igg Antibodies And Derivatives/Nipocalimab-Aahu
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Nipocalimab-aahu binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medicines that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of nipocalimab-aahu states that nipocalimab-aahu should not be combined with long-term use of FcRn-binding medications. If the medication is essential for the patient, nipocalimab-aahu should be discontinued.(3)
DISCUSSION: Clinical drug interaction studies with nipocalimab-aahu have not been performed. Nipocalimab-aahu may decrease concentrations of compounds that bind to the human FcRn.(3)
Immunosuppres;Immunomodul/Selected Multiple Sclerosis Agents
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ocrelizumab or ofatumumab in combination with immunosuppressives and immune-modulators all suppress the immune system.(1,2)
CLINICAL EFFECTS: Concurrent use of ocrelizumab or ofatumumab with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1,2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ocrelizumab US prescribing information states: - Ocrelizumab and other immune-modulating or immunosuppressive therapies, (including immunosuppressant doses of corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with ocrelizumab. When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating ocrelizumab.(1) The ofatumumab US prescribing information states: - Ofatumumab and other immunosuppressive therapies (including systemic corticosteroids) may have the potential for increased immunosuppressive effects and increase the risk of infection. When switching between therapies, the duration and mechanism of action of each therapy should be considered due to the potential for additive immunosuppressive effects. Ofatumumab for MS therapy has not been studied in combination with other MS agents that suppress the immune system.(2)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1,2) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(3)
Immunosuppressives; Immunomodulators/Baricitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of baricitinib with other biologic disease-modifying antirheumatic drugs (DMARDs) or potent immunosuppressants such as azathioprine or cyclosporine may result in additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of baricitinib with other biologic DMARDs or potent immunosuppressants such as azathioprine or cyclosporine may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of baricitinib states that concurrent use of baricitinib with biologic DMARDs or potent immunosuppressants is not recommended.(1)
DISCUSSION: Most patients who developed serious infections while being treated with baricitinib were on concomitant immunosuppressants like methotrexate and corticosteroids. The combination of baricitinib with other biologic DMARDs has not been studied.(1)
Immunosuppressives; Immunomodulators/Cladribine Oral
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-2)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-2)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The cladribine US prescribing information states: -Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. Acute short-term therapy with corticosteroids can be administered. In patients who have previously been treated with immunomodulatory or immunosuppressive drugs, consider potential additive effect, the mode of action, and duration of effect of the other drugs prior to initiation of cladribine.(1) The cladribine Canadian prescribing information states: -Use of cladribine in immunocompromised patients is contraindicated because of a risk of additive effects on the immune system. Acute short-term therapy with corticosteroids can be administered during cladribine treatment.(2)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-2)
Immunosuppressives; Immunomodulators/Deuruxolitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Deuruxolitinib, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of deuruxolitinib and potent immunosuppressants may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of deuruxolitinib states that concurrent use of deuruxolitinib with other JAK inhibitors, biologic immunomodulators, cyclosporine or other potent immunosuppressants is not recommended.(1) If concurrent use cannot be avoided, patients should be monitored for signs and symptoms of infection. If a patient develops a serious or opportunistic infection, interrupt deuruxolitinib treatment until the infection is controlled.
DISCUSSION: Serious infections have been reported in patients receiving treatment with deuruxolitinib.(1)
Immunosuppressives; Immunomodulators/Etrasimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues, resulting in a mean 55% decrease in peripheral blood lymphocyte count at 52 weeks.(1) Other immunosuppressives and immune-modulators also suppress the immune system.
CLINICAL EFFECTS: Concurrent use of etrasimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious and fatal infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications increases the risk of adverse effects.
PATIENT MANAGEMENT: The etrasimod US prescribing information states etrasimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Concomitant administration of these therapies with etrasimod should be avoided because of the risk of additive immune effects during therapy and in the weeks following administration. Etrasimod's effect on peripheral lymphocytes may persist for up to 5 weeks after discontinuation.(1) When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients treated with other sphingosine-1 phosphate receptor modulators.(1)
Immunosuppressives; Immunomodulators/Filgotinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic disease-modifying antirheumatic drugs (DMARDs), or other Janus kinase (JAK) inhibitors may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic DMARDs, or other JAK inhibitors may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The UK manufacturer of filgotinib states that concurrent use of filgotinib with other immunosuppressants or immunomodulators including azathioprine, cyclosporine, tacrolimus, biologic DMARDs, or other JAK inhibitors is not recommended.(1)
DISCUSSION: Serious infections have been reported in patients receiving filgotinib. Caution should be used in patients with a higher incidence of serious infection, including elderly patients aged 75 years and older.(1)
Immunosuppressives; Immunomodulators/Fingolimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Fingolimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-3)
CLINICAL EFFECTS: Concurrent use of fingolimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-3)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for fingolimod regarding this interaction differ between regulatory approving agencies. The fingolimod US prescribing information states: - Antineoplastic, immune-modulating, or immunosuppressive therapies, (including corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with fingolimod. When switching from drugs with prolonged immune effects, such as natalizumab, teriflunomide or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating fingolimod.(1) The fingolimod Canadian prescribing information states: - Concurrent use with immunosuppressive or immunomodulatory agents is contraindicated due to the risk of additive immune system effects. However, co-administration of a short course of corticosteroids (up to 5 days) did not increase the overall rate of infection in patients participating Phase III clinical trials.(2) The fingolimod UK specific product characteristics states: - Fingolimod is contraindicated in patients currently receiving immunosuppressive therapies or those immunocompromised by prior therapies. When switching patients from another disease modifying therapy to Gilenya, the half-life and mode of action of the other therapy must be considered in order to avoid an additive immune effect whilst at the same time minimizing the risk of disease activation.(3)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-3)
Immunosuppressives; Immunomodulators/Inebilizumab
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Inebilizumab, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of inebilizumab with immunosuppressive or immunomodulating agents may result in myelosuppression including neutropenia resulting in an increased risk for serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of inebilizumab states that the concurrent use of inebilizumab with immunosuppressive agents, including systemic corticosteroids, may increase the risk of infection. If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents.(1)
DISCUSSION: Inebilizumab has not been studied in combination with other immunosuppressants. If concurrent therapy is warranted, consider the potential for increased immunosuppressive risks from both agents. The most common infections reported by inebilizumab treated patients in the randomized and open-label clinical trial periods included urinary tract infections (20%), nasopharyngitis (13%), upper respiratory tract infections (8%), and influenza (7%). Although there been no cases of Hepatitis B virus reactivation or progressive multifocal leukoencephalopathy reported in patients taking inebilizumab, these infections have been observed in patients taking other B-cell-depleting antibodies.(1)
Immunosuppressives; Immunomodulators/Ozanimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ozanimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ozanimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ozanimod US prescribing information state this information regarding this interaction: -Ozanimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ozanimod after alemtuzumab is not recommended. However, ozanimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Ponesimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ponesimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ponesimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The ponesimod US prescribing information states ponesimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ponesimod after alemtuzumab is not recommended. However, ponesimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Ritlecitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ritlecitinib, immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of ritlecitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of ritlecitinib states that concurrent use of ritlecitinib with other JAK inhibitors, biologic immunomodulators, cyclosporine or other potent immunosuppressants is not recommended.(1)
DISCUSSION: Serious infections have been reported in patients receiving ritlecitinib. Reported infections included appendicitis, COVID-19 infection (including pneumonia), and sepsis. Reports of viral reactivation, including herpes virus reactivation was reported in clinical studies with ritlecitinib.(1)
Immunosuppressives; Immunomodulators/Siponimod
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Siponimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of siponimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The siponimod US prescribing information state this information regarding this interaction: -Siponimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with siponimod after alemtuzumab is not recommended. However, siponimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1)
DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1)
Immunosuppressives; Immunomodulators/Tofacitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Concurrent use of tofacitinib and azathioprine, other biologic disease-modifying antirheumatic drugs (DMARDs), or potent immunosuppressants may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants use may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Tofacitinib should not be used concurrently with azathioprine, other biologic DMARDs, or cyclosporine.(1) Patient should be monitored for decreases in lymphocytes and neutrophils. Therapy should be adjusted based on the indication. - For all indications: If absolute neutrophil count (ANC) or lymphocyte count is less than 500 cells/mm3, discontinue tofacitinib. - For rheumatoid arthritis or psoriatic arthritis and absolute neutrophil count (ANC) 500 to 1000 cells/mm3: interrupt dosing. When ANC is greater than 1000 cells/mm3, resume Xeljanz 5 mg twice daily or Xeljanz XR 11 mg once daily. - For ulcerative colitis and ANC 500 to 1000 cells/mm3: -If taking Xeljanz 10 mg twice daily, decrease to 5 mg twice daily. When ANC is greater than 1000 cells/mm3, increase to 10 mg twice daily based on clinical response. -If taking Xeljanz 5 mg twice daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 5 mg twice daily. -If taking Xeljanz XR 22 mg once daily, decrease to 11 mg once daily. When ANC is greater than 1000 cells/mm3, increase to 22 mg once daily based on clinical response. -If taking Xeljanz XR 11 mg once daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 11 mg once daily. - For polyarticular course juvenile idiopathic arthritis (pcJIA) and ANC 500 to 1000 cells/mm3: interrupt dosing until ANC is greater than 1000 cells/mm3.(1)
DISCUSSION: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants may increase the risk of infection.(1) Serious infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving tofacitinib. Some patients presented with disseminated disease and were often taking concomitant immunomodulating agents. In the ulcerative colitis population, a greater risk of serious infections was seen with a higher tofacitinib dose. In 7 placebo-controlled rheumatoid arthritis trials (0-3 months exposure), the overall frequency of infections was 20% in the tofacitinib 5 mg twice daily group and 22% in the tofacitinib 10 mg twice daily group compared to 18% in the placebo group. Serious infections were reported in 11 patients (1.7 events per 100 patient-years) with a rate difference between treatment groups of 1.1 (-0.4, 2.5) events per 100 patient-years for both tofacitinib 5 mg twice daily and 10 mg twice daily. During 0-12 months exposure, serious infections were reported in 34 patients (2.7 events per 100 patient years) in the tofacitinib 5 mg twice daily group and 33 patients (2.7 events per 100 patient years) in the tofacitinib 10 mg twice daily group.(1)
Immunosuppressives; Immunomodulators/Upadacitinib
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Upadacitinib, immunosuppressives, and immunomodulators all suppress the immune system.
CLINICAL EFFECTS: Concurrent use of upadacitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of upadacitinib states that concurrent use of upadacitinib with immunosuppressives or immunomodulators is not recommended.
DISCUSSION: Serious infections have been reported in patients receiving upadacitinib. Reported infections included pneumonia, cellulitis, tuberculosis, multidermatomal herpes zoster, oral/esophageal candidiasis, cryptococcosis. Reports of viral reactivation, including herpes virus reactivation and hepatitis B reactivation, were reported in clinical studies with upadacitinib.(1)
Slt Immunosuppress; Immunomodulator/Ropeginterferon Alfa-2B
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Ropeginterferon alfa-2b and immunosuppressives both suppress the immune system.
CLINICAL EFFECTS: Concurrent use of ropeginterferon alfa-2b with immunosuppressives may result in an increased risk of serious infections.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Avoid concurrent use of myelosuppressive agents.(1-2) If concurrent use cannot be avoided, monitor for effects of excessive immunosuppression.
DISCUSSION: In clinical trials, 20% of patients experienced leukopenia. Interferon alfa products may cause fatal or life-threatening infections.(1-2)
Tnf Blockers/Azathioprine; Mercaptopurine
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: The exact mechanism is unknown, but may involve additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of a TNF blocker with either azathioprine or mercaptopurine may increase the risk of hepatosplenic T-cell lymphoma (HSTCL), a rare but usually fatal cancer.(1-3)
PREDISPOSING FACTORS: The majority of reports of hepatosplenic T cell lymphoma in patients receiving concurrent TNF blockers with either azathioprine or mercaptopurine have occurred in patients with Crohn's disease or ulcerative colitis; however, there is one report in a psoriasis patient and two reports in rheumatoid arthritis patients.(1) The majority of patients were adolescent or young males.(2)
PATIENT MANAGEMENT: Patients receiving concurrent therapy with TNF blockers and either azathioprine or mercaptopurine should be counseled on the risk of developing hepatosplenic T-cell lymphoma, a rare but usually fatal cancer. They should be counseled on the signs and symptoms of malignancies such as HSTCL, which may include splenomegaly, hepatomegaly, abdominal pain, persistent fever, night sweats, and weight loss.
DISCUSSION: From initiation of TNF marketing to December 31, 2010, the FDA has received 28 reports of hepatosplenic T-cell lymphoma (HSTCL) in patients receiving TNF blockers: infliximab (20), etanercept (1), adalimumab (2), infliximab/adalimumab (5), certolizumab (0), golimumab (0). In 22 of these cases, the patients were also receiving azathioprine or mercaptopurine (18 with infliximab, 4 with infliximab/adalimumab).(1)
Tumor Necrosis Factor (Tnf) Inhibitors/Interleukin-1 Blocker
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Possibly additive or synergistic effects on the immune system.
CLINICAL EFFECTS: Concurrent use of anakinra, canakinumab, or rilonacept and a tumor necrosis factor (TNF) inhibitor may increase the risk of severe infection and/or neutropenia(1-9) without providing any clinical benefit.(4-6)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of anakinra states that concurrent use of anakinra with tumor necrosis factor (TNF) blocking agents certolizumab, etanercept, and infliximab is not recommended.(1) The Canadian(2) and US(3) manufacturers of adalimumab, the US manufacturer of certolizumab,(4) and the US manufacturer of golimumab,(4) and the US manufacturer of infliximab(7) state that concurrent therapy with anakinra is not recommended. The Australian manufacturers of infliximab, adalimumab, etanercept, and golimumab state that concurrent use with anakinra is contraindicated.(11-14) The Australian manufacturer of anakinra states that concurrent therapy with TNF inhibitors is contraindicated.(15) The US manufacturers of rilonacept(8) and canakinumab(9) state that concurrent use with TNF blocking agents is not recommended. Patients receiving concurrent therapy should be closely monitored for signs of infection and neutropenia.(10)
DISCUSSION: Preliminary data suggest a higher rate of serious infections (7%) in patients treated concurrently with anakinra and etanercept compared to when anakinra is administered alone (2%)(1) or when etanercept is administered alone (0%).(5,8) The most common infections were bacterial pneumonia (4 cases) and cellulitis (4 cases). One patient with pulmonary fibrosis and pneumonia died from respiratory failure.(6) Preliminary data also suggest a higher rate of neutropenia (2-3%) when anakinra is administered with etanercept.(1,6) Data also suggest that the combination provides no added clinical benefit.(6)
Moderate Interaction: Assess the risk to the patient and take action as needed.
Biologic Therapies/Belimumab
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Concurrent use of belimumab with other biologic therapies may result in additive or synergistic effects on the immune system.(1)
CLINICAL EFFECTS: Concurrent use of belimumab with other biologic therapies may increase the risk of serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of belimumab with other biologic therapies should be approached with caution.(1)
DISCUSSION: In a randomized, double-blind, placebo-controlled trial, more patients who received belimumab and rituximab experienced serious adverse events, serious infections, and post-injection systemic reactions (22.2%, 9%, and 13.2%, respectively) than patients who received belimumab with placebo (13.9%, 2.8%, 9.7%) or standard therapy (19.7%, 5.3%, 5.3%).(1) The combination of belimumab with other biologic therapies has not been studied and should be used cautiously.(1)
Igg Antibodies And Derivatives/Rozanolixizumab-Noli
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: The neonatal Fc receptor (FcRn) prevents catabolism and mediates recycling of IgG and albumin, which leads to their long persistence in the body.(1,2) Rozanolixizumab-noli binds to FcRn and may decrease systemic exposure of other ligands of FcRn, like immunoglobulins and IgG-based antibodies.(3)
CLINICAL EFFECTS: The effectiveness of medications that bind to FcRn may be decreased.(3)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of rozanolixizumab-noli states that concurrent use with medications that bind to the human neonatal Fc receptor (FcRn) should be closely monitored for reduced effectiveness of these medications. If long-term use of such medications is essential for the patient, consider discontinuing rozanolixizumab-noli and use alternative therapies.(3)
DISCUSSION: Clinical drug interaction studies with rozanolixizumab-noli have not been performed. Rozanolixizumab-noli may decrease concentrations of compounds that bind to the human FcRn.(3)
Immunosuppressives; Immunomodulators/Cladribine Oncology Inj
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-4)
CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections.(1-4)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The cladribine US, UK, and Australian prescribing information state: -Caution should be exercised if cladribine injection is administered before, after, or in conjunction with other drugs known to cause immunosuppression or myelosuppression.(1-3) The cladribine Canadian prescribing information states: -Proceed carefully in patients with severe bone marrow impairment of any etiology since further suppression of bone marrow function should be anticipated.(4)
DISCUSSION: Severe bone marrow suppression, including neutropenia, anemia and thrombocytopenia, has been commonly observed in patients treated with cladribine injection, especially at high doses.(1-4)
Immunosuppressives; Immunomodulators/Ublituximab
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Ublituximab, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ublituximab with immunosuppressive or immunomodulating agents may result in an increased risk for serious infections.(1)
PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications.
PATIENT MANAGEMENT: The US manufacturer of ublituximab recommends caution because the concurrent use of ublituximab with immunomodulating or immunosuppressive agents, including immunosuppressant doses of corticosteroids, may increase the risk of infection.(1) If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents. When switching from agents with immune effects, the half-life and mechanism of action of these drugs must be taken into consideration in order to prevent additive immunosuppressive effects.(1)
DISCUSSION: The most common infections reported by ublituximab-treated patients in the clinical trial periods included upper respiratory tract infections and urinary tract infections. Serious, including life-threatening or fatal, bacterial and viral infections were observed in patients receiving ublituximab.(1) Serious and/or fatal bacterial, fungal, and new or reactivated viral infections have been associated with other anti-CD20 B-cell depleting therapies. There were no cases of progressive multifocal leukoencephalopathy (PML) reported during the clinical trials; however, there have been reports of PML during or following completion of other anti-CD20 B-cell depleting therapies.(1)
Immunosuppressives; Immunomodulators/Ustekinumab
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Ustekinumab, immunosuppressives, and immunomodulators all suppress the immune system.(1)
CLINICAL EFFECTS: Concurrent use of ustekinumab with immunosuppressive or immunomodulating agents may result in an increased risk for serious infections.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of ustekinumab recommends caution because the concurrent use of ustekinumab with immunosuppressive agents may increase the risk of infection. If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents.(1)
DISCUSSION: Ustekinumab has not been studied in combination with other immunosuppressants in psoriasis studies. In psoriatic arthritis studies, concomitant methotrexate use did not appear to influence the safety or efficacy of ustekinumab. In Crohn's disease and ulcerative colitis studies, concomitant use of immunosuppressants or corticosteroids did not appear to influence the safety or efficacy of ustekinumab. If concurrent therapy is warranted, consider the potential for increased immunosuppressive risks from both agents.(1) The most common infections reported by ustekinumab treated patients in the clinical trial periods included nasopharyngitis(8%) and upper respiratory tract infection(5%). Serious bacterial, mycobacterial, fungal, and viral infections were observed in patients receiving ustekinumab. Cases of interstitial pneumonia, eosinophilic pneumonia, and cryptogenic organizing pneumonia resulting in respiratory failure or prolonged hospitalization have been reported in patients receiving ustekinumab.(1)
Contraindications
*None.
- Active tuberculosis
- Sepsis
- Basal cell carcinoma of skin
- Chronic heart failure
- Demyelinating disorder
- Extrapulmonary pneumocystosis
- Guillain-barre syndrome
- Hepatosplenic t-cell lymphoma
- Inactive tuberculosis
- Infection
- Leukemia
- Malignancy
- Malignant lymphoma
- Multiple sclerosis
- Neutropenic disorder
- Opportunistic fungal infection
- Opportunistic viral infection
- Pancytopenia
- Pneumocystis jirovecii pneumonia
- Thrombocytopenic disorder
- Viral hepatitis B
There are no moderate contraindications for this drug.
Adverse reactions
Common adverse effects reported in 10% or more of patients receiving adalimumab include infections (e.g., upper respiratory, sinusitis), injection site reactions, headache, and rash.
More Frequent
- Dehydration
- Infection
- Lupus-like syndrome
- Skin rash
- Upper respiratory infection
Less Frequent
- Abnormal hepatic function tests
- Accidental injury
- Acute myocardial infarction
- Agranulocytosis
- Asthma
- Atrial fibrillation
- Avascular necrosis of bone
- Biliary calculus
- Bronchospastic pulmonary disease
- Cardiac arrest
- Cardiac arrhythmia
- Cataracts
- Chest pain
- Chronic heart failure
- Cystitis
- Dyspnea
- Erysipelas
- Erythrocytosis
- Flu-like symptoms
- Fracture
- Fungal infection
- Gastrointestinal hemorrhage
- Hepatic necrosis
- Herpes zoster
- Hypertension
- Hypertensive crisis
- Increased alanine transaminase
- Ketosis
- Kidney stone
- Leg vein thrombosis
- Leukopenia
- Malignant lymphoma
- Monoclonal gammopathy
- Multiple sclerosis
- Palpitations
- Pericardial effusion
- Pericarditis
- Peripheral edema
- Pneumonia
- Pseudohypoparathyroidism
- Pyelonephritis
- Reactivated tuberculosis
- Secondary polycythemia
- Subdural intracranial hemorrhage
- Syncope
- Tachycardia
- Urinary tract infection
Rare or Very Rare
- Active tuberculosis
- Anaphylaxis
- Angioedema
- Aplastic anemia
- Appendicitis
- Autoimmune hepatitis
- Bacterial sepsis
- Basal cell carcinoma of skin
- Blastomycosis
- Cellulitis
- Cerebrovascular accident
- Cholecystitis
- Coccidioidomycosis
- Cutaneous vasculitis
- Deep venous thrombosis
- Demyelinating disorder
- Diverticulitis of gastrointestinal tract
- Drug-exacerbated psoriasis
- Erythema multiforme
- Guillain-barre syndrome
- Heart failure
- Hepatic failure
- Hepatitis
- Hepatosplenic t-cell lymphoma
- Histoplasmosis
- Hypersensitivity drug reaction
- Interstitial lung disease
- Intestinal perforation
- Legionnaires' disease
- Leukemia
- Listeriosis
- Malignancy
- Malignant melanoma
- Merkel cell carcinoma
- Opportunistic fungal infection
- Optic neuritis
- Pancreatitis
- Pancytopenia
- Protozoal infection
- Pulmonary fibrosis
- Pulmonary thromboembolism
- Reactivation of hepatitis B
- Sarcoidosis
- Squamous cell carcinoma of skin
- Stevens-johnson syndrome
- Thrombocytopenic disorder
- Thrombotic disorder
- Vasculitis
- Worsening of chronic heart failure
More Frequent
- Headache disorder
- Injection site sequelae
- Nausea
- Pharyngitis
- Pruritus of skin
- Sinusitis
Less Frequent
- Acute abdominal pain
- Acute cognitive impairment
- Arthritis
- Back pain
- Cramps
- Esophagitis
- Gastroenteritis
- Hematuria
- Hypercholesterolemia
- Hyperlipidemia
- Impaired wound healing
- Injection site erythema
- Muscle weakness
- Pain in extremities
- Paresthesia
- Pelvic pain
- Pleural effusions
- Septic arthritis
- Synovitis
- Tremor
- Vomiting
Rare or Very Rare
- Alopecia
- Fever
- Granuloma annulare
- Lichenoid dermatitis drug eruption
- Menstrual disorder
- Urticaria
Precautions
No enhanced messaging available.
Safety and efficacy of adalimumab for uses other than polyarticular juvenile idiopathic arthritis, Crohn disease, ulcerative colitis, and noninfectious uveitis have not been established in pediatric patients. Use of adalimumab for the management of hidradenitis suppurativa in adolescents is supported by clinical trials in adults. For marketing exclusivity reasons, adalimumab biosimilars are not labeled for use in pediatric patients with ulcerative colitis, hidradenitis suppurativa, or noninfectious uveitis.
Use of adalimumab for the management of polyarticular juvenile idiopathic arthritis in pediatric patients 2 years of age or older is supported by results of a safety and efficacy study in pediatric patients 4-17 years of age and additional data from a study in children 2 to <4 years of age indicating that the safety profile in this age group is similar to that in pediatric patients 4-17 years of age. In these studies, the types and frequencies of adverse effects generally were similar to those observed in adults. Safety and efficacy of adalimumab for the management of polyarticular juvenile idiopathic arthritis have not been established in pediatric patients less than 2 years of age or in those who weigh less than 10 kg.
Use of adalimumab for the management of Crohn disease in pediatric patients 6 years of age or older is supported by evidence from adequate and well-controlled studies in adults and additional data from a randomized, double-blind, 52-week clinical study of 2 dosage levels of the drug in 192 pediatric patients 6-17 years of age with moderately to severely active Crohn disease. Safety and efficacy for the management of Crohn disease have not been established in pediatric patients less than 6 years of age.
Use of adalimumab for the management of ulcerative colitis in pediatric patients 5 years of age or older is supported by evidence from adequate and well-controlled studies in adults and additional data from a randomized, double-blind, 52-week clinical study of 2 dosage levels of the drug in 93 pediatric patients 5-17 years of age with moderately to severely active ulcerative colitis. The recommended dosage of adalimumab in pediatric patients with ulcerative colitis is based on modeled dose/exposure-efficacy relationships and pharmacokinetic data; clinically relevant differences between the studied higher dosage administered in the clinical trial and the recommended dosage are not anticipated. Efficacy of adalimumab has not been established in patients who have lost response or were intolerant to TNF blocking agents. Safety and efficacy for the management of ulcerative colitis have not been established in pediatric patients less than 5 years of age.
Use of adalimumab for the management of noninfectious uveitis in pediatric patients 2 years of age or older is supported by evidence from adequate and well-controlled studies in adults and a randomized, controlled study in 90 pediatric patients. Safety and efficacy for the management of noninfectious uveitis have not been established in pediatric patients less than 2 years of age.
Use of adalimumab for the management of hidradenitis suppurativa in pediatric patients 12 years of age or older is supported by evidence from adequate and well-controlled studies in adults. The course of hidradenitis suppurativa in adults and adolescents is sufficiently similar to allow extrapolation of data from adults to adolescents. Population pharmacokinetic modeling and simulation data suggest that weight-based dosing in pediatric patients 12 years of age or older will provide exposure levels that are generally similar to those achieved in adults. Safety and efficacy for the management of hidradenitis suppurativa have not been established in pediatric patients less than 12 years of age.
When use of adalimumab is being considered for pediatric patients, review the vaccination status of the child and administer all age-appropriate vaccines included in current immunization guidelines.
Malignancies, some fatal, have been reported in children and adolescents who received treatment with TNF blocking agents, including adalimumab.
Neonates and infants who were exposed to adalimumab in utero may have impaired immune responses. Data from 8 infants exposed to adalimumab in utero suggest that the drug crosses the placenta; the clinical importance of elevated adalimumab concentrations in infants is unknown. Consider the risks and benefits of administering live vaccines to infants who were exposed to adalimumab in utero, since the safety of live vaccines in these infants is unknown.
Available studies of adalimumab use during pregnancy do not reliably establish an association between the drug and major birth defects. Results of a prospective, controlled, observational, pregnancy registry cohort study of pregnancy outcomes in adalimumab-treated females with rheumatoid arthritis or Crohn disease indicated that 10% of females in the adalimumab-exposed cohort (8.7% of those with rheumatoid arthritis, 10.5% of those with Crohn disease) delivered a live-born infant with a major birth defect, compared with 7.5% of females with rheumatoid arthritis or Crohn disease who had not been exposed to the drug (6.8% of those with rheumatoid arthritis, 9.4% of those with Crohn disease); however, no pattern of major birth defects was observed, and differences in the cohorts may have affected the observed occurrence rates. All females in the adalimumab-exposed cohort were exposed to the drug for some period of time during the first trimester of pregnancy; 65% were exposed to the drug in all 3 trimesters. The study utilized data from the Organization of Teratology Information Specialists (OTIS)/MotherToBaby pregnancy registry from 2004-2016 and included data for 602 pregnant females, including 257 females with rheumatoid arthritis or Crohn disease who had been exposed to adalimumab during pregnancy, 120 disease-matched unexposed females, and 225 healthy unexposed females. Methodologic limitations of the registry study (e.g., small sample size, voluntary nature of the study, nonrandomized design) preclude drawing definitive conclusions regarding the risk of major birth defects.
In an embryofetal-perinatal development study in cynomolgus monkeys, no fetal harm or malformations were observed at adalimumab exposure levels of up to approximately 373 times the exposure achieved at the maximum recommended human dosage (MRHD) for use without methotrexate.
Data suggest that increased disease activity in females with rheumatoid arthritis or inflammatory bowel disease is associated with an increased risk of adverse pregnancy outcomes (e.g., preterm delivery, low birth weight, small size for gestational age at birth).
As pregnancy progresses, monoclonal antibodies are increasingly transported across the placenta, with the largest amount transferred during the third trimester. Adalimumab is actively transferred across the placenta during the third trimester of pregnancy. Results of a study in 10 pregnant females receiving adalimumab for treatment of inflammatory bowel disease (last dose administered 1-56 days prior to delivery) suggest that adalimumab may be detectable in the serum of infants exposed to the drug in utero for at least 3 months following birth. Adalimumab concentrations in cord blood were higher than maternal serum concentrations in 9 women in this study, and one infant had detectable serum concentrations of the drug measured through 11 weeks of age.
Adalimumab may affect immune response in infants exposed to the drug in utero. Consider the risks and benefits of administering live vaccines to such infants, since the safety of live vaccines in infants exposed to the drug in utero is unknown.
Limited data indicate that small amounts of adalimumab distribute into human milk (0.1-1% of maternal serum concentrations) and suggest that systemic exposure to adalimumab in nursing infants is likely to be low since the drug is a large molecule and is degraded in the GI tract. However, the effects of local exposure in the GI tract are unknown. There are no reports of adverse effects of adalimumab on breast-fed infants or effects of the drug on milk production.
Consider the developmental and health benefits of breast-feeding along with the mother's clinical need for adalimumab and any potential adverse effects on the breast-fed child from the drug or underlying maternal condition.
The manufacturer makes no specific dosage recommendations for geriatric patients.
No substantial differences in efficacy have been observed in geriatric patients with rheumatoid arthritis relative to younger adults. The incidence of serious infection and malignancy in adalimumab-treated patients greater than 65 years of age is higher than the incidence in younger adults receiving the drug. Because the overall incidence of infection and malignancy is higher in the geriatric population in general than in younger adults, consider the risks and benefits of adalimumab in geriatric patients and closely monitor for the development of infection or malignancy if adalimumab is used.
ICD codes
| Code | Type | Description |
|---|---|---|
| Ankylosing spondylitis | ||
| M08.1 | ICD10CM | Juvenile ankylosing spondylitis |
| M45 | ICD10CM | Ankylosing spondylitis |
| M45.0 | ICD10CM | Ankylosing spondylitis of multiple sites in spine |
| M45.1 | ICD10CM | Ankylosing spondylitis of occipito-atlanto-axial region |
| M45.2 | ICD10CM | Ankylosing spondylitis of cervical region |
| M45.3 | ICD10CM | Ankylosing spondylitis of cervicothoracic region |
| M45.4 | ICD10CM | Ankylosing spondylitis of thoracic region |
| M45.5 | ICD10CM | Ankylosing spondylitis of thoracolumbar region |
| M45.6 | ICD10CM | Ankylosing spondylitis lumbar region |
| M45.7 | ICD10CM | Ankylosing spondylitis of lumbosacral region |
| M45.8 | ICD10CM | Ankylosing spondylitis sacral and sacrococcygeal region |
| M45.9 | ICD10CM | Ankylosing spondylitis of unspecified sites in spine |
| Crohn's disease | ||
| K50 | ICD10CM | Crohn's disease [regional enteritis] |
| K50.0 | ICD10CM | Crohn's disease of small intestine |
| K50.00 | ICD10CM | Crohn's disease of small intestine without complications |
| K50.01 | ICD10CM | Crohn's disease of small intestine with complications |
| K50.011 | ICD10CM | Crohn's disease of small intestine with rectal bleeding |
| K50.012 | ICD10CM | Crohn's disease of small intestine with intestinal obstruction |
| K50.013 | ICD10CM | Crohn's disease of small intestine with fistula |
| K50.014 | ICD10CM | Crohn's disease of small intestine with abscess |
| K50.018 | ICD10CM | Crohn's disease of small intestine with other complication |
| K50.019 | ICD10CM | Crohn's disease of small intestine with unspecified complications |
| K50.1 | ICD10CM | Crohn's disease of large intestine |
| K50.10 | ICD10CM | Crohn's disease of large intestine without complications |
| K50.11 | ICD10CM | Crohn's disease of large intestine with complications |
| K50.111 | ICD10CM | Crohn's disease of large intestine with rectal bleeding |
| K50.112 | ICD10CM | Crohn's disease of large intestine with intestinal obstruction |
| K50.113 | ICD10CM | Crohn's disease of large intestine with fistula |
| K50.114 | ICD10CM | Crohn's disease of large intestine with abscess |
| K50.118 | ICD10CM | Crohn's disease of large intestine with other complication |
| K50.119 | ICD10CM | Crohn's disease of large intestine with unspecified complications |
| K50.8 | ICD10CM | Crohn's disease of both small and large intestine |
| K50.80 | ICD10CM | Crohn's disease of both small and large intestine without complications |
| K50.81 | ICD10CM | Crohn's disease of both small and large intestine with complications |
| K50.811 | ICD10CM | Crohn's disease of both small and large intestine with rectal bleeding |
| K50.812 | ICD10CM | Crohn's disease of both small and large intestine with intestinal obstruction |
| K50.813 | ICD10CM | Crohn's disease of both small and large intestine with fistula |
| K50.814 | ICD10CM | Crohn's disease of both small and large intestine with abscess |
| K50.818 | ICD10CM | Crohn's disease of both small and large intestine with other complication |
| K50.819 | ICD10CM | Crohn's disease of both small and large intestine with unspecified complications |
| K50.9 | ICD10CM | Crohn's disease, unspecified |
| K50.90 | ICD10CM | Crohn's disease, unspecified, without complications |
| K50.91 | ICD10CM | Crohn's disease, unspecified, with complications |
| K50.911 | ICD10CM | Crohn's disease, unspecified, with rectal bleeding |
| K50.912 | ICD10CM | Crohn's disease, unspecified, with intestinal obstruction |
| K50.913 | ICD10CM | Crohn's disease, unspecified, with fistula |
| K50.914 | ICD10CM | Crohn's disease, unspecified, with abscess |
| K50.918 | ICD10CM | Crohn's disease, unspecified, with other complication |
| K50.919 | ICD10CM | Crohn's disease, unspecified, with unspecified complications |
| Hidradenitis suppurativa | ||
| L73.2 | ICD10CM | Hidradenitis suppurativa |
| Moderate to severe plaque psoriasis | ||
| L40.0 | ICD10CM | Psoriasis vulgaris |
| L40.8 | ICD10CM | Other psoriasis |
| L40.9 | ICD10CM | Psoriasis, unspecified |
| Non-infectious uveitis | ||
| D86.83 | ICD10CM | Sarcoid iridocyclitis |
| H20.00 | ICD10CM | Unspecified acute and subacute iridocyclitis |
| H20.04 | ICD10CM | Secondary noninfectious iridocyclitis |
| H20.041 | ICD10CM | Secondary noninfectious iridocyclitis, right eye |
| H20.042 | ICD10CM | Secondary noninfectious iridocyclitis, left eye |
| H20.043 | ICD10CM | Secondary noninfectious iridocyclitis, bilateral |
| H20.049 | ICD10CM | Secondary noninfectious iridocyclitis, unspecified eye |
| H20.10 | ICD10CM | Chronic iridocyclitis, unspecified eye |
| H20.82 | ICD10CM | Vogt-koyanagi syndrome |
| H20.821 | ICD10CM | Vogt-koyanagi syndrome, right eye |
| H20.822 | ICD10CM | Vogt-koyanagi syndrome, left eye |
| H20.823 | ICD10CM | Vogt-koyanagi syndrome, bilateral |
| H20.829 | ICD10CM | Vogt-koyanagi syndrome, unspecified eye |
| H30.14 | ICD10CM | Acute posterior multifocal placoid pigment epitheliopathy |
| H30.141 | ICD10CM | Acute posterior multifocal placoid pigment epitheliopathy, right eye |
| H30.142 | ICD10CM | Acute posterior multifocal placoid pigment epitheliopathy, left eye |
| H30.143 | ICD10CM | Acute posterior multifocal placoid pigment epitheliopathy, bilateral |
| H30.149 | ICD10CM | Acute posterior multifocal placoid pigment epitheliopathy, unspecified eye |
| H30.81 | ICD10CM | Harada's disease |
| H30.811 | ICD10CM | Harada's disease, right eye |
| H30.812 | ICD10CM | Harada's disease, left eye |
| H30.813 | ICD10CM | Harada's disease, bilateral |
| H30.819 | ICD10CM | Harada's disease, unspecified eye |
| H44.11 | ICD10CM | Panuveitis |
| H44.111 | ICD10CM | Panuveitis, right eye |
| H44.112 | ICD10CM | Panuveitis, left eye |
| H44.113 | ICD10CM | Panuveitis, bilateral |
| H44.119 | ICD10CM | Panuveitis, unspecified eye |
| H44.13 | ICD10CM | Sympathetic uveitis |
| H44.131 | ICD10CM | Sympathetic uveitis, right eye |
| H44.132 | ICD10CM | Sympathetic uveitis, left eye |
| H44.133 | ICD10CM | Sympathetic uveitis, bilateral |
| H44.139 | ICD10CM | Sympathetic uveitis, unspecified eye |
| Polyarticular juvenile idiopathic arthritis | ||
| M08.0 | ICD10CM | Unspecified juvenile rheumatoid arthritis |
| M08.00 | ICD10CM | Unspecified juvenile rheumatoid arthritis of unspecified site |
| M08.01 | ICD10CM | Unspecified juvenile rheumatoid arthritis, shoulder |
| M08.011 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right shoulder |
| M08.012 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left shoulder |
| M08.019 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified shoulder |
| M08.02 | ICD10CM | Unspecified juvenile rheumatoid arthritis of elbow |
| M08.021 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right elbow |
| M08.022 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left elbow |
| M08.029 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified elbow |
| M08.03 | ICD10CM | Unspecified juvenile rheumatoid arthritis, wrist |
| M08.031 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right wrist |
| M08.032 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left wrist |
| M08.039 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified wrist |
| M08.04 | ICD10CM | Unspecified juvenile rheumatoid arthritis, hand |
| M08.041 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right hand |
| M08.042 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left hand |
| M08.049 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified hand |
| M08.05 | ICD10CM | Unspecified juvenile rheumatoid arthritis, hip |
| M08.051 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right hip |
| M08.052 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left hip |
| M08.059 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified hip |
| M08.06 | ICD10CM | Unspecified juvenile rheumatoid arthritis, knee |
| M08.061 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right knee |
| M08.062 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left knee |
| M08.069 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified knee |
| M08.07 | ICD10CM | Unspecified juvenile rheumatoid arthritis, ankle and foot |
| M08.071 | ICD10CM | Unspecified juvenile rheumatoid arthritis, right ankle and foot |
| M08.072 | ICD10CM | Unspecified juvenile rheumatoid arthritis, left ankle and foot |
| M08.079 | ICD10CM | Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.08 | ICD10CM | Unspecified juvenile rheumatoid arthritis, vertebrae |
| M08.09 | ICD10CM | Unspecified juvenile rheumatoid arthritis, multiple sites |
| M08.0A | ICD10CM | Unspecified juvenile rheumatoid arthritis, other specified site |
| M08.2 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset |
| M08.20 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified site |
| M08.21 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, shoulder |
| M08.211 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right shoulder |
| M08.212 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left shoulder |
| M08.219 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified shoulder |
| M08.22 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, elbow |
| M08.221 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right elbow |
| M08.222 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left elbow |
| M08.229 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified elbow |
| M08.23 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, wrist |
| M08.231 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right wrist |
| M08.232 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left wrist |
| M08.239 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified wrist |
| M08.24 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, hand |
| M08.241 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right hand |
| M08.242 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left hand |
| M08.249 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified hand |
| M08.25 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, hip |
| M08.251 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right hip |
| M08.252 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left hip |
| M08.259 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified hip |
| M08.26 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, knee |
| M08.261 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right knee |
| M08.262 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left knee |
| M08.269 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified knee |
| M08.27 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, ankle and foot |
| M08.271 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, right ankle and foot |
| M08.272 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, left ankle and foot |
| M08.279 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, unspecified ankle and foot |
| M08.28 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, vertebrae |
| M08.29 | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, multiple sites |
| M08.2A | ICD10CM | Juvenile rheumatoid arthritis with systemic onset, other specified site |
| M08.3 | ICD10CM | Juvenile rheumatoid polyarthritis (seronegative) |
| M08.4 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis |
| M08.40 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified site |
| M08.41 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, shoulder |
| M08.411 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right shoulder |
| M08.412 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left shoulder |
| M08.419 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified shoulder |
| M08.42 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, elbow |
| M08.421 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right elbow |
| M08.422 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left elbow |
| M08.429 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified elbow |
| M08.43 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, wrist |
| M08.431 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right wrist |
| M08.432 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left wrist |
| M08.439 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified wrist |
| M08.44 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, hand |
| M08.441 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right hand |
| M08.442 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left hand |
| M08.449 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified hand |
| M08.45 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, hip |
| M08.451 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right hip |
| M08.452 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left hip |
| M08.459 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified hip |
| M08.46 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, knee |
| M08.461 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right knee |
| M08.462 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left knee |
| M08.469 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified knee |
| M08.47 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, ankle and foot |
| M08.471 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, right ankle and foot |
| M08.472 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, left ankle and foot |
| M08.479 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.48 | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, vertebrae |
| M08.4A | ICD10CM | Pauciarticular juvenile rheumatoid arthritis, other specified site |
| Psoriatic arthritis | ||
| L40.5 | ICD10CM | Arthropathic psoriasis |
| L40.50 | ICD10CM | Arthropathic psoriasis, unspecified |
| L40.51 | ICD10CM | Distal interphalangeal psoriatic arthropathy |
| L40.52 | ICD10CM | Psoriatic arthritis mutilans |
| L40.53 | ICD10CM | Psoriatic spondylitis |
| L40.54 | ICD10CM | Psoriatic juvenile arthropathy |
| L40.59 | ICD10CM | Other psoriatic arthropathy |
| Rheumatoid arthritis | ||
| M05 | ICD10CM | Rheumatoid arthritis with rheumatoid factor |
| M05.0 | ICD10CM | Felty's syndrome |
| M05.00 | ICD10CM | Felty's syndrome, unspecified site |
| M05.01 | ICD10CM | Felty's syndrome, shoulder |
| M05.011 | ICD10CM | Felty's syndrome, right shoulder |
| M05.012 | ICD10CM | Felty's syndrome, left shoulder |
| M05.019 | ICD10CM | Felty's syndrome, unspecified shoulder |
| M05.02 | ICD10CM | Felty's syndrome, elbow |
| M05.021 | ICD10CM | Felty's syndrome, right elbow |
| M05.022 | ICD10CM | Felty's syndrome, left elbow |
| M05.029 | ICD10CM | Felty's syndrome, unspecified elbow |
| M05.03 | ICD10CM | Felty's syndrome, wrist |
| M05.031 | ICD10CM | Felty's syndrome, right wrist |
| M05.032 | ICD10CM | Felty's syndrome, left wrist |
| M05.039 | ICD10CM | Felty's syndrome, unspecified wrist |
| M05.04 | ICD10CM | Felty's syndrome, hand |
| M05.041 | ICD10CM | Felty's syndrome, right hand |
| M05.042 | ICD10CM | Felty's syndrome, left hand |
| M05.049 | ICD10CM | Felty's syndrome, unspecified hand |
| M05.05 | ICD10CM | Felty's syndrome, hip |
| M05.051 | ICD10CM | Felty's syndrome, right hip |
| M05.052 | ICD10CM | Felty's syndrome, left hip |
| M05.059 | ICD10CM | Felty's syndrome, unspecified hip |
| M05.06 | ICD10CM | Felty's syndrome, knee |
| M05.061 | ICD10CM | Felty's syndrome, right knee |
| M05.062 | ICD10CM | Felty's syndrome, left knee |
| M05.069 | ICD10CM | Felty's syndrome, unspecified knee |
| M05.07 | ICD10CM | Felty's syndrome, ankle and foot |
| M05.071 | ICD10CM | Felty's syndrome, right ankle and foot |
| M05.072 | ICD10CM | Felty's syndrome, left ankle and foot |
| M05.079 | ICD10CM | Felty's syndrome, unspecified ankle and foot |
| M05.09 | ICD10CM | Felty's syndrome, multiple sites |
| M05.1 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis |
| M05.10 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified site |
| M05.11 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of shoulder |
| M05.111 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right shoulder |
| M05.112 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left shoulder |
| M05.119 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder |
| M05.12 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of elbow |
| M05.121 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right elbow |
| M05.122 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left elbow |
| M05.129 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified elbow |
| M05.13 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of wrist |
| M05.131 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right wrist |
| M05.132 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left wrist |
| M05.139 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified wrist |
| M05.14 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of hand |
| M05.141 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right hand |
| M05.142 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left hand |
| M05.149 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified hand |
| M05.15 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of hip |
| M05.151 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right hip |
| M05.152 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left hip |
| M05.159 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified hip |
| M05.16 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of knee |
| M05.161 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right knee |
| M05.162 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left knee |
| M05.169 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified knee |
| M05.17 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of ankle and foot |
| M05.171 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot |
| M05.172 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of left ankle and foot |
| M05.179 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.19 | ICD10CM | Rheumatoid lung disease with rheumatoid arthritis of multiple sites |
| M05.2 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis |
| M05.20 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified site |
| M05.21 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of shoulder |
| M05.211 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right shoulder |
| M05.212 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left shoulder |
| M05.219 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified shoulder |
| M05.22 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of elbow |
| M05.221 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right elbow |
| M05.222 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left elbow |
| M05.229 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified elbow |
| M05.23 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of wrist |
| M05.231 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right wrist |
| M05.232 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left wrist |
| M05.239 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified wrist |
| M05.24 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of hand |
| M05.241 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right hand |
| M05.242 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left hand |
| M05.249 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hand |
| M05.25 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of hip |
| M05.251 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right hip |
| M05.252 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left hip |
| M05.259 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hip |
| M05.26 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of knee |
| M05.261 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right knee |
| M05.262 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left knee |
| M05.269 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified knee |
| M05.27 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of ankle and foot |
| M05.271 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot |
| M05.272 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of left ankle and foot |
| M05.279 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of unspecified ankle and foot |
| M05.29 | ICD10CM | Rheumatoid vasculitis with rheumatoid arthritis of multiple sites |
| M05.3 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis |
| M05.30 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified site |
| M05.31 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of shoulder |
| M05.311 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right shoulder |
| M05.312 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left shoulder |
| M05.319 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified shoulder |
| M05.32 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of elbow |
| M05.321 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right elbow |
| M05.322 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left elbow |
| M05.329 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified elbow |
| M05.33 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of wrist |
| M05.331 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right wrist |
| M05.332 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left wrist |
| M05.339 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified wrist |
| M05.34 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of hand |
| M05.341 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right hand |
| M05.342 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left hand |
| M05.349 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified hand |
| M05.35 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of hip |
| M05.351 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right hip |
| M05.352 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left hip |
| M05.359 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified hip |
| M05.36 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of knee |
| M05.361 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right knee |
| M05.362 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left knee |
| M05.369 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified knee |
| M05.37 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of ankle and foot |
| M05.371 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of right ankle and foot |
| M05.372 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of left ankle and foot |
| M05.379 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.39 | ICD10CM | Rheumatoid heart disease with rheumatoid arthritis of multiple sites |
| M05.4 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis |
| M05.40 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified site |
| M05.41 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of shoulder |
| M05.411 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right shoulder |
| M05.412 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left shoulder |
| M05.419 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified shoulder |
| M05.42 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of elbow |
| M05.421 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right elbow |
| M05.422 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left elbow |
| M05.429 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified elbow |
| M05.43 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of wrist |
| M05.431 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right wrist |
| M05.432 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left wrist |
| M05.439 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified wrist |
| M05.44 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of hand |
| M05.441 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right hand |
| M05.442 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left hand |
| M05.449 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified hand |
| M05.45 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of hip |
| M05.451 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right hip |
| M05.452 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left hip |
| M05.459 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified hip |
| M05.46 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of knee |
| M05.461 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right knee |
| M05.462 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left knee |
| M05.469 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified knee |
| M05.47 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of ankle and foot |
| M05.471 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot |
| M05.472 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot |
| M05.479 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.49 | ICD10CM | Rheumatoid myopathy with rheumatoid arthritis of multiple sites |
| M05.5 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis |
| M05.50 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site |
| M05.51 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of shoulder |
| M05.511 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder |
| M05.512 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder |
| M05.519 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder |
| M05.52 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of elbow |
| M05.521 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow |
| M05.522 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow |
| M05.529 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified elbow |
| M05.53 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of wrist |
| M05.531 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist |
| M05.532 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist |
| M05.539 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified wrist |
| M05.54 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of hand |
| M05.541 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right hand |
| M05.542 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left hand |
| M05.549 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hand |
| M05.55 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of hip |
| M05.551 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right hip |
| M05.552 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left hip |
| M05.559 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip |
| M05.56 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of knee |
| M05.561 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right knee |
| M05.562 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left knee |
| M05.569 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified knee |
| M05.57 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of ankle and foot |
| M05.571 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot |
| M05.572 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot |
| M05.579 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.59 | ICD10CM | Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites |
| M05.6 | ICD10CM | Rheumatoid arthritis with involvement of other organs and systems |
| M05.60 | ICD10CM | Rheumatoid arthritis of unspecified site with involvement of other organs and systems |
| M05.61 | ICD10CM | Rheumatoid arthritis of shoulder with involvement of other organs and systems |
| M05.611 | ICD10CM | Rheumatoid arthritis of right shoulder with involvement of other organs and systems |
| M05.612 | ICD10CM | Rheumatoid arthritis of left shoulder with involvement of other organs and systems |
| M05.619 | ICD10CM | Rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems |
| M05.62 | ICD10CM | Rheumatoid arthritis of elbow with involvement of other organs and systems |
| M05.621 | ICD10CM | Rheumatoid arthritis of right elbow with involvement of other organs and systems |
| M05.622 | ICD10CM | Rheumatoid arthritis of left elbow with involvement of other organs and systems |
| M05.629 | ICD10CM | Rheumatoid arthritis of unspecified elbow with involvement of other organs and systems |
| M05.63 | ICD10CM | Rheumatoid arthritis of wrist with involvement of other organs and systems |
| M05.631 | ICD10CM | Rheumatoid arthritis of right wrist with involvement of other organs and systems |
| M05.632 | ICD10CM | Rheumatoid arthritis of left wrist with involvement of other organs and systems |
| M05.639 | ICD10CM | Rheumatoid arthritis of unspecified wrist with involvement of other organs and systems |
| M05.64 | ICD10CM | Rheumatoid arthritis of hand with involvement of other organs and systems |
| M05.641 | ICD10CM | Rheumatoid arthritis of right hand with involvement of other organs and systems |
| M05.642 | ICD10CM | Rheumatoid arthritis of left hand with involvement of other organs and systems |
| M05.649 | ICD10CM | Rheumatoid arthritis of unspecified hand with involvement of other organs and systems |
| M05.65 | ICD10CM | Rheumatoid arthritis of hip with involvement of other organs and systems |
| M05.651 | ICD10CM | Rheumatoid arthritis of right hip with involvement of other organs and systems |
| M05.652 | ICD10CM | Rheumatoid arthritis of left hip with involvement of other organs and systems |
| M05.659 | ICD10CM | Rheumatoid arthritis of unspecified hip with involvement of other organs and systems |
| M05.66 | ICD10CM | Rheumatoid arthritis of knee with involvement of other organs and systems |
| M05.661 | ICD10CM | Rheumatoid arthritis of right knee with involvement of other organs and systems |
| M05.662 | ICD10CM | Rheumatoid arthritis of left knee with involvement of other organs and systems |
| M05.669 | ICD10CM | Rheumatoid arthritis of unspecified knee with involvement of other organs and systems |
| M05.67 | ICD10CM | Rheumatoid arthritis of ankle and foot with involvement of other organs and systems |
| M05.671 | ICD10CM | Rheumatoid arthritis of right ankle and foot with involvement of other organs and systems |
| M05.672 | ICD10CM | Rheumatoid arthritis of left ankle and foot with involvement of other organs and systems |
| M05.679 | ICD10CM | Rheumatoid arthritis of unspecified ankle and foot with involvement of other organs and systems |
| M05.69 | ICD10CM | Rheumatoid arthritis of multiple sites with involvement of other organs and systems |
| M05.7 | ICD10CM | Rheumatoid arthritis with rheumatoid factor without organ or systems involvement |
| M05.70 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement |
| M05.71 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of shoulder without organ or systems involvement |
| M05.711 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right shoulder without organ or systems involvement |
| M05.712 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left shoulder without organ or systems involvement |
| M05.719 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified shoulder without organ or systems involvement |
| M05.72 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of elbow without organ or systems involvement |
| M05.721 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right elbow without organ or systems involvement |
| M05.722 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left elbow without organ or systems involvement |
| M05.729 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified elbow without organ or systems involvement |
| M05.73 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement |
| M05.731 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right wrist without organ or systems involvement |
| M05.732 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left wrist without organ or systems involvement |
| M05.739 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified wrist without organ or systems involvement |
| M05.74 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement |
| M05.741 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right hand without organ or systems involvement |
| M05.742 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left hand without organ or systems involvement |
| M05.749 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified hand without organ or systems involvement |
| M05.75 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement |
| M05.751 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right hip without organ or systems involvement |
| M05.752 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left hip without organ or systems involvement |
| M05.759 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified hip without organ or systems involvement |
| M05.76 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement |
| M05.761 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right knee without organ or systems involvement |
| M05.762 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left knee without organ or systems involvement |
| M05.769 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified knee without organ or systems involvement |
| M05.77 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement |
| M05.771 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement |
| M05.772 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or systems involvement |
| M05.779 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot without organ or systems involvement |
| M05.79 | ICD10CM | Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement |
| M05.7A | ICD10CM | Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement |
| M05.8 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor |
| M05.80 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified site |
| M05.81 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of shoulder |
| M05.811 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right shoulder |
| M05.812 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left shoulder |
| M05.819 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified shoulder |
| M05.82 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of elbow |
| M05.821 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right elbow |
| M05.822 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left elbow |
| M05.829 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified elbow |
| M05.83 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of wrist |
| M05.831 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right wrist |
| M05.832 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left wrist |
| M05.839 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified wrist |
| M05.84 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of hand |
| M05.841 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right hand |
| M05.842 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left hand |
| M05.849 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified hand |
| M05.85 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of hip |
| M05.851 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right hip |
| M05.852 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left hip |
| M05.859 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified hip |
| M05.86 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of knee |
| M05.861 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right knee |
| M05.862 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left knee |
| M05.869 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified knee |
| M05.87 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of ankle and foot |
| M05.871 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of right ankle and foot |
| M05.872 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of left ankle and foot |
| M05.879 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot |
| M05.89 | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of multiple sites |
| M05.8A | ICD10CM | Other rheumatoid arthritis with rheumatoid factor of other specified site |
| M05.9 | ICD10CM | Rheumatoid arthritis with rheumatoid factor, unspecified |
| M05.A | ICD10CM | Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis |
| M06 | ICD10CM | Other rheumatoid arthritis |
| M06.0 | ICD10CM | Rheumatoid arthritis without rheumatoid factor |
| M06.00 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified site |
| M06.01 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, shoulder |
| M06.011 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right shoulder |
| M06.012 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left shoulder |
| M06.019 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified shoulder |
| M06.02 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, elbow |
| M06.021 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right elbow |
| M06.022 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left elbow |
| M06.029 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified elbow |
| M06.03 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, wrist |
| M06.031 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right wrist |
| M06.032 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left wrist |
| M06.039 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified wrist |
| M06.04 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, hand |
| M06.041 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right hand |
| M06.042 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left hand |
| M06.049 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified hand |
| M06.05 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, hip |
| M06.051 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right hip |
| M06.052 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left hip |
| M06.059 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified hip |
| M06.06 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, knee |
| M06.061 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right knee |
| M06.062 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left knee |
| M06.069 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified knee |
| M06.07 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, ankle and foot |
| M06.071 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, right ankle and foot |
| M06.072 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, left ankle and foot |
| M06.079 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, unspecified ankle and foot |
| M06.08 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, vertebrae |
| M06.09 | ICD10CM | Rheumatoid arthritis without rheumatoid factor, multiple sites |
| M06.0A | ICD10CM | Rheumatoid arthritis without rheumatoid factor, other specified site |
| M06.8 | ICD10CM | Other specified rheumatoid arthritis |
| M06.80 | ICD10CM | Other specified rheumatoid arthritis, unspecified site |
| M06.81 | ICD10CM | Other specified rheumatoid arthritis, shoulder |
| M06.811 | ICD10CM | Other specified rheumatoid arthritis, right shoulder |
| M06.812 | ICD10CM | Other specified rheumatoid arthritis, left shoulder |
| M06.819 | ICD10CM | Other specified rheumatoid arthritis, unspecified shoulder |
| M06.82 | ICD10CM | Other specified rheumatoid arthritis, elbow |
| M06.821 | ICD10CM | Other specified rheumatoid arthritis, right elbow |
| M06.822 | ICD10CM | Other specified rheumatoid arthritis, left elbow |
| M06.829 | ICD10CM | Other specified rheumatoid arthritis, unspecified elbow |
| M06.83 | ICD10CM | Other specified rheumatoid arthritis, wrist |
| M06.831 | ICD10CM | Other specified rheumatoid arthritis, right wrist |
| M06.832 | ICD10CM | Other specified rheumatoid arthritis, left wrist |
| M06.839 | ICD10CM | Other specified rheumatoid arthritis, unspecified wrist |
| M06.84 | ICD10CM | Other specified rheumatoid arthritis, hand |
| M06.841 | ICD10CM | Other specified rheumatoid arthritis, right hand |
| M06.842 | ICD10CM | Other specified rheumatoid arthritis, left hand |
| M06.849 | ICD10CM | Other specified rheumatoid arthritis, unspecified hand |
| M06.85 | ICD10CM | Other specified rheumatoid arthritis, hip |
| M06.851 | ICD10CM | Other specified rheumatoid arthritis, right hip |
| M06.852 | ICD10CM | Other specified rheumatoid arthritis, left hip |
| M06.859 | ICD10CM | Other specified rheumatoid arthritis, unspecified hip |
| M06.86 | ICD10CM | Other specified rheumatoid arthritis, knee |
| M06.861 | ICD10CM | Other specified rheumatoid arthritis, right knee |
| M06.862 | ICD10CM | Other specified rheumatoid arthritis, left knee |
| M06.869 | ICD10CM | Other specified rheumatoid arthritis, unspecified knee |
| M06.87 | ICD10CM | Other specified rheumatoid arthritis, ankle and foot |
| M06.871 | ICD10CM | Other specified rheumatoid arthritis, right ankle and foot |
| M06.872 | ICD10CM | Other specified rheumatoid arthritis, left ankle and foot |
| M06.879 | ICD10CM | Other specified rheumatoid arthritis, unspecified ankle and foot |
| M06.88 | ICD10CM | Other specified rheumatoid arthritis, vertebrae |
| M06.89 | ICD10CM | Other specified rheumatoid arthritis, multiple sites |
| M06.8A | ICD10CM | Other specified rheumatoid arthritis, other specified site |
| M06.9 | ICD10CM | Rheumatoid arthritis, unspecified |
| Ulcerative colitis | ||
| K51 | ICD10CM | Ulcerative colitis |
| K51.0 | ICD10CM | Ulcerative (chronic) pancolitis |
| K51.00 | ICD10CM | Ulcerative (chronic) pancolitis without complications |
| K51.01 | ICD10CM | Ulcerative (chronic) pancolitis with complications |
| K51.011 | ICD10CM | Ulcerative (chronic) pancolitis with rectal bleeding |
| K51.012 | ICD10CM | Ulcerative (chronic) pancolitis with intestinal obstruction |
| K51.013 | ICD10CM | Ulcerative (chronic) pancolitis with fistula |
| K51.014 | ICD10CM | Ulcerative (chronic) pancolitis with abscess |
| K51.018 | ICD10CM | Ulcerative (chronic) pancolitis with other complication |
| K51.019 | ICD10CM | Ulcerative (chronic) pancolitis with unspecified complications |
| K51.2 | ICD10CM | Ulcerative (chronic) proctitis |
| K51.20 | ICD10CM | Ulcerative (chronic) proctitis without complications |
| K51.21 | ICD10CM | Ulcerative (chronic) proctitis with complications |
| K51.211 | ICD10CM | Ulcerative (chronic) proctitis with rectal bleeding |
| K51.212 | ICD10CM | Ulcerative (chronic) proctitis with intestinal obstruction |
| K51.213 | ICD10CM | Ulcerative (chronic) proctitis with fistula |
| K51.214 | ICD10CM | Ulcerative (chronic) proctitis with abscess |
| K51.218 | ICD10CM | Ulcerative (chronic) proctitis with other complication |
| K51.219 | ICD10CM | Ulcerative (chronic) proctitis with unspecified complications |
| K51.3 | ICD10CM | Ulcerative (chronic) rectosigmoiditis |
| K51.30 | ICD10CM | Ulcerative (chronic) rectosigmoiditis without complications |
| K51.31 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with complications |
| K51.311 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with rectal bleeding |
| K51.312 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with intestinal obstruction |
| K51.313 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with fistula |
| K51.314 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with abscess |
| K51.318 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with other complication |
| K51.319 | ICD10CM | Ulcerative (chronic) rectosigmoiditis with unspecified complications |
| K51.5 | ICD10CM | Left sided colitis |
| K51.50 | ICD10CM | Left sided colitis without complications |
| K51.51 | ICD10CM | Left sided colitis with complications |
| K51.511 | ICD10CM | Left sided colitis with rectal bleeding |
| K51.512 | ICD10CM | Left sided colitis with intestinal obstruction |
| K51.513 | ICD10CM | Left sided colitis with fistula |
| K51.514 | ICD10CM | Left sided colitis with abscess |
| K51.518 | ICD10CM | Left sided colitis with other complication |
| K51.519 | ICD10CM | Left sided colitis with unspecified complications |
| K51.8 | ICD10CM | Other ulcerative colitis |
| K51.80 | ICD10CM | Other ulcerative colitis without complications |
| K51.81 | ICD10CM | Other ulcerative colitis with complications |
| K51.811 | ICD10CM | Other ulcerative colitis with rectal bleeding |
| K51.812 | ICD10CM | Other ulcerative colitis with intestinal obstruction |
| K51.813 | ICD10CM | Other ulcerative colitis with fistula |
| K51.814 | ICD10CM | Other ulcerative colitis with abscess |
| K51.818 | ICD10CM | Other ulcerative colitis with other complication |
| K51.819 | ICD10CM | Other ulcerative colitis with unspecified complications |
| K51.9 | ICD10CM | Ulcerative colitis, unspecified |
| K51.90 | ICD10CM | Ulcerative colitis, unspecified, without complications |
| K51.91 | ICD10CM | Ulcerative colitis, unspecified, with complications |
| K51.911 | ICD10CM | Ulcerative colitis, unspecified with rectal bleeding |
| K51.912 | ICD10CM | Ulcerative colitis, unspecified with intestinal obstruction |
| K51.913 | ICD10CM | Ulcerative colitis, unspecified with fistula |
| K51.914 | ICD10CM | Ulcerative colitis, unspecified with abscess |
| K51.918 | ICD10CM | Ulcerative colitis, unspecified with other complication |
| K51.919 | ICD10CM | Ulcerative colitis, unspecified with unspecified complications |
ICD code information from First Databank (FDB).
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Last reviewed · Source: First Databank (FDB) drug data
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