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Infliximab (Remicade)
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Infliximab is a biologic response modifier, or biologic in the class of drugs called TNF-alpha inhibitors. It gained its first approval by the FDA for the treatment of Crohn's disease in 1998. It has since then been approved for the treatment of 6 other inflammatory diseases.

Mechanism: Infliximab is a chimeric IgG1k monoclonal antibody (composed of human constant and murine variable regions) specific for human TNF-alpha. Infliximab neutralizes the biological activity of TNF-alpha by binding with high affinity to the soluble and transmembrane forms of TNF-alpha and inhibits binding of TNF-alpha with its receptors. Infliximab is given by IV infusion unlike the other TNF-alpha inhibitors which are given subcutaneously.

Uses:

  • Crohn's Disease
  • Pediatric Crohn's Disease
  • Ulcerative Colitis
  • Pediatric Ulcerative Colitis
  • Rheumatoid Arthritis
  • Ankylosing Spondylitis
  • Psoriatic Arthritis
  • Plaque Psoriasis

Side effects: The side effect profile of Infliximab is similar to other drugs in its class. The most common side effects are infections (e.g. upper respiratory, sinusitis, and pharyngitis), infusion-related reactions, headache, and abdominal pain. Some of the more serious side effects include hepatotoxicity, malignancy (lymphoma and other cancers), myelosuppression, lupus like syndrome, demyelinating disease, heart failure, opportunistic infections, and reactivation of hepatitis or tuberculosis. Therefore, all patients who are candidates for treatment with infliximab need to undergo testing for tuberculosis and hepatitis before beginning treatment, since these diseases can become reactivated.

 

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