| TNF alpha is a protein that is produced during the | | | | Infliximab should be discontinued if serious reactions |
| inflammatory response. It both starts as well as | | | | occur. |
| perpetuates inflammation. Increased levels of TNF | | | | Serious infections have been reported with other |
| are found in several inflammatory conditions including | | | | drugs that block TNF- alpha, and infections have been |
| rheumatoid arthritis, psoriatic arthritis, and ankylosing | | | | reported during treatment with infliximab. Therefore, |
| spondylitis. Drugs that block tumor necrosis factor | | | | infliximab should not be used in patients with serious |
| (TNF) have been found to be particularly effective | | | | infections. Infliximab should be discontinued if a |
| for the treatment of these serious types of | | | | serious infection develops during treatment. |
| inflammatory arthritis. | | | | Before starting infliximab, persons should have |
| Infliximab (Remicade) is a monoclonal chimeric | | | | tuberculosis skin testing, because of reports of |
| antibody (part human, part mouse) directed against | | | | reactivation of tuberculosis in patients taking |
| TNF alpha. | | | | infliximab. |
| Infliximab is approved for use alone or combined with | | | | There have been rare cases of serious liver injury in |
| methotrexate for treating moderate to severe | | | | people taking infliximab. Screening for hepatitis B may |
| rheumatoid arthritis. It also is approved for the | | | | be a good idea. |
| treatment of active psoriatic arthritis and ankylosing | | | | Infliximab should not be used in patients with |
| spondylitis. | | | | congestive heart failure or other significant heart |
| Infliximab is administered intravenously. The | | | | disease. |
| recommended dose for the treatment of rheumatoid | | | | Approximately half of infliximab-treated patients in |
| arthritis is 3 mg/kg as a single dose. The initial dose | | | | clinical trials developed a positive ANA during the trial |
| should be followed by additional 3 mg/kg doses two | | | | compared with approximately one-fifth of |
| and six weeks after the first dose. The maintenance | | | | placebo-treated patients. Anti-dsDNA antibodies were |
| dose depends on the patient's response. It can be | | | | newly detected in approximately one-fifth of |
| increased to a maximum of 10 mg/kg every 4 | | | | infliximab-treated patients compared with 0% of |
| weeks. | | | | placebo-treated patients. Reports of lupus and |
| The most common side effects of infliximab are | | | | lupus-like syndromes, however, remain uncommon. |
| upper respiratory tract infections, urinary tract | | | | Decreased white and red blood cell and decreased |
| infections, cough, rash, back pain, nausea, vomiting, | | | | platelet counts have been reported with infliximab. |
| abdominal pain, headache, weakness and fever. | | | | Vasculitis (inflammation of arteries) also has been |
| Infusion reactions, which are sometimes severe, may | | | | reported. |
| occur. | | | | Patients with rheumatoid arthritis, particularly patients |
| Side effects such as blood pressure changes, chest | | | | with very active disease and/or chronic exposure to |
| pain, shortness of breath, rash, itching, fever and | | | | immunosuppressive therapies, may be at a higher risk |
| chills may occur during or shortly after administration. | | | | (up to several fold) than the general population for |
| These reactions could possibly be due to an allergy | | | | the development of lymphoma. It is not known |
| to the drug. They are more common among patients | | | | whether anti-TNF therapy raises this level of risk. |
| who develop antibodies to infliximab and are less | | | | Infliximab should not be used in combination with |
| likely to occur in patients who are taking drugs that | | | | anakinra (Kineret). |
| suppress the immune system, such as methotrexate. | | | | |