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Infliximab Brand Names- AVSOLA | INFLECTRA | IXIFI | Remicade | RENFLEXIS
What is Infliximab
Infliximab is a chimeric IgG1k monoclonal antibody targeted against tumor necrosis factor-alpha (TNF-alpha), also known as a TNF-blocker.
Infliximab was the first of the tumor necrosis factor (TNF) modifiers marketed in the U.S. Infliximab, like other TNF blockers, is effective in a variety of inflammatory conditions. Infliximab is approved in adults for the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis.
In adults with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) the drug improves clinical signs and symptoms, inhibits the radiographic progression of structural joint damage, and improves physical function; in adults with ankylosing spondylitis (AS), the drug improves clinical signs and symptoms of active disease, which can improve quality of life. For adult RA, infliximab is usually given along with methotrexate.
For adult PsA or AS, infliximab may be used as monotherapy; the drug may also be used with other disease-modifying antirheumatic agents (DMARDs). The ideal combination of therapy for individual patients with inflammatory arthritis conditions is determined by treat to target strategies and severity of disease.
For PsA, TNF-blockers are considered a first-line treatment, even in treatment-naive patients.
Infliximab is beneficial in adults with moderate to severe plaque psoriasis; TNF-blockers may be used as first-line systemic treatments alone or in combination with other therapies.
Infliximab is also used for patients with inflammatory bowel disease (IBD) and is effective for adult and pediatric patients 6 years of age and older for Crohn’s disease and ulcerative colitis.
The effectiveness of infliximab has been demonstrated for both active moderately to severely active luminal Crohn’s disease and for fistulizing Crohn’s disease, where the drug helps induce and maintain clinical remission.
In moderately to severely active ulcerative colitis patients with an inadequate response to conventional therapy, the drug can induce and maintain clinical remission and mucosal healing, and may reduce corticosteroid use.
As with other TNF blockers, infliximab labeling carries a boxed warning regarding the risk for serious infections, including tuberculosis, and the potential risk of malignancy.
Indications
- ankylosing spondylitis
- Behcet’s syndrome
- Crohn’s disease
- Kawasaki disease
- psoriasis
- psoriatic arthritis
- rheumatoid arthritis
- ulcerative colitis
- uveitis
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agranulocytosis
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angina
- antibody formation
- arthralgia
- bone fractures
- bradycardia
- bronchospasm
- candidiasis
- cervical cancer
- chest pain (unspecified)
- chills
- cholestasis
- constipation
- cough
- dehydration
- diarrhea
- dizziness
- dyspepsia
- dysphagia
- dyspnea
- edema
- elevated hepatic enzymes
- erythema multiforme
- fatigue
- fever
- flushing
- GI obstruction
- Guillain-Barre syndrome
- headache
- heart failure
- hemolytic anemia
- hepatic encephalopathy
- hepatic failure
- hepatitis
- hyperhidrosis
- hypertension
- hypotension
- infection
- infusion-related reactions
- jaundice
- laryngeal edema
- leukopenia
- lichen planus-like eruption
- lupus-like symptoms
- lymphadenopathy
- lymphoma
- Merkel cell carcinoma
- myalgia
- myelitis
- myocardial infarction
- nausea
- neutropenia
- new primary malignancy
- optic neuritis
- pancytopenia
- pericardial effusion
- pharyngitis
- phlebitis
- pneumonitis
- pruritus
- psoriaform rash
- pulmonary edema
- pulmonary fibrosis
- rash
- seizures
- serum sickness
- sinusitis
- skin cancer
- skin ulcer
- Stevens-Johnson syndrome
- stroke
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- toxic epidermal necrolysis
- urticaria
- vasculitis
- visual impairment
- weight loss
Monitoring Parameters
- CBC with differential
- hepatitis B serology
- skin cancer screening exam
- tuberculin skin test
Contraindications
- autoimmune disease
- bone marrow suppression
- breast-feeding
- cervical cancer
- children
- chronic obstructive pulmonary disease (COPD)
- corticosteroid therapy
- diabetes mellitus
- fungal infection
- Guillain-Barre syndrome
- heart failure
- hematological disease
- hepatitis
- hepatotoxicity
- herpes infection
- human anti-chimeric antibody (HACA)
- immunosuppression
- infants
- infection
- infusion-related reactions
- jaundice
- leukopenia
- lymphoma
- Merkel cell carcinoma
- multiple sclerosis
- murine protein hypersensitivity
- mycobacterial infection
- neonates
- neurological disease
- neutropenia
- new primary malignancy
- optic neuritis
- pregnancy
- seizure disorder
- seizures
- sepsis
- skin cancer
- thrombocytopenia
- tobacco smoking
- tuberculosis
- vaccination
- vasculitis
- viral infection
Interactions
- Abatacept
- Adalimumab
- Anakinra
- Antithymocyte Globulin
- Azathioprine
- Baricitinib
- Belimumab
- Canakinumab
- Certolizumab pegol
- Cyclosporine
- Daclizumab
- Dexamethasone
- Etanercept
- Golimumab
- Live Vaccines
- Mercaptopurine, 6-MP
- Methotrexate
- Methylprednisolone
- Mycophenolate
- Natalizumab
- Pexidartinib
- Prednisone
- Rilonacept
- Riluzole
- Rituximab
- Rituximab; Hyaluronidase
- Sarilumab
- Sirolimus
- Tacrolimus
- Theophylline, Aminophylline
- Tocilizumab
- Tofacitinib
- Tuberculin Purified Protein Derivative, PPD
- Upadacitinib
- Vedolizumab
- Warfarin
