Rheumatology Book

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InfliximabAka: Remicade

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  1. See Also
    1. Etanercept (Enbrel)
    2. Adalimumab (Humira)
  2. Indications
    1. Moderate to severe refractory Crohn's Disease
    2. Refractory Rheumatoid Arthritis
      1. Added to Methotrexate or with other agents
  3. Contraindications
    1. Histoplasmosis
    2. Coccidioidomycosis
    3. Tuberculosis
  4. Mechanism
    1. Anti-TNF alpha Monoclonal Antibody
      1. Monoclonal Antibody binds Tumor necrosis factor alpha
  5. Pharmacokinetics
    1. Half life of 5 mg/kg single dose: 10 days
  6. Disadvantages
    1. Cost: $2380/dose (cost to pharmacist)
  7. Dose: Crohn's Disease
    1. Initial: 5 mg/kg IV infusion over 2 hours
    2. Repeat at 2 weeks and 6 weeks for fistulas
  8. Dose: Rheumatoid Arthritis
    1. Initial: 3 mg/kg IV at 0 weeks, 2 weeks and 6 weeks
    2. Maintenance: 3 mg/kg IV every 8 weeks (6x/year)
    3. Dosing range is 3-10 mg/kg (typically higher doses than 3 mg needed with longterm use)
  9. Efficacy: Crohn's Disease
    1. Significant response to remission even with fistulas
    2. Relapse may occur after 3 months
  10. Adverse effects
    1. Safety of repeated use unknown
    2. Serum Sickness
    3. Lymphoma
    4. Opportunistic Infection
      1. Associated with granulomatous infection
        1. Tuberculosis
        2. Histoplasmosis
      2. Higher risk of infection than with Etanercept
        1. Wallis (2004) Clin Infect Dis 38:1261
  11. Drug Interactions
    1. Acetaminophen
    2. Benadryl
    3. Solu-Medrol
    4. Epinephrine
  12. References
    1. (1999) Med Lett Drugs Ther 41(1047):19
    2. Maini (2000) :

infliximab (C0666743)

Definition (NCI)A monoclonal antibody that blocks the action of a cytokine called tumor necrosis factor alfa. It is being studied in the treatment and prevention of weight loss and loss of appetite in patients with advanced cancer. It belongs to the family of drugs called monoclonal antibodies.
Definition (PDQ)A recombinant chimeric, mouse-human monoclonal antibody directed against tumor necrosis factor alpha (TNF-alpha), a protein involved in inflammation, cell survival, and apoptosis. Infliximab may be pro- apoptotic or anti-apoptotic, depending on cell type. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38698&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38698&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1789" NCI Thesaurus)
Definition (NCI)A recombinant chimeric, mouse-human monoclonal antibody directed against tumor necrosis factor alpha (TNF-alpha), a protein involved in inflammation, cell survival, and apoptosis. Infliximab may be pro- apoptotic or anti-apoptotic, depending on cell type. (NCI04)
ConceptsAmino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Immunologic Factor (T129)
EnglishINF, INFLIX, infliximab, MAb cA2, monoclonal antibody cA2
Spanishinfliximab
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Remicade (C0723012)

ConceptsAmino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Immunologic Factor (T129)
EnglishCentocor brand of infliximab, Essex brand of infliximab, Remicade, Schering brand of infliximab
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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