Infliximab - Frequently Asked Questions
What is infliximab?
Infliximab is a treatment for rheumatoid arthritis (RA) that works quickly to suppress inflammation caused by your immune system. This can help to relieve your symptoms and prevent your RA from progressing. The first version of infliximab to be produced is known by the brand name “Remicade”. There are other versions of infliximab, which are very similar to Remicade, but not identical in terms of their molecular structure. Clinical trials have shown that these alternative versions, called biosimilars, have the same chance of clinical benefit and risk as the “originator” drug, Remicade, from which they are copied. But the expectation is that the biosimilar drugs will cost less than Remicade. The first example of a biosimilar infliximab, was approved for use in the UK in 2015 and is known by the brand name “Inflectra”.
How does infliximab work?
In RA the body over-produces a substance known as TNF-alpha. This is one of the causes of inflammation, and may lead to many of the symptoms of these conditions such as joint swelling, stiffness and discomfort. In RA, if inflammation is not suppressed, joint damage often results.
Infliximab is a “TNF-alpha antagonist”. This means that it works by neutralising TNF-alpha. This reduces inflammation and so can lessen the symptoms associated with RA. It can also help stop further joint damage.
How is infliximab different from other TNF-alpha antagonist treatments?
Unlike other anti-TNFs, which are given by self-administered injections, infliximab is given by a drip (IV infusion), which is administered by a healthcare professional.
Why has my doctor prescribed infliximab?
If you have severe active and progressive RA your doctor may prescribe infliximab to reduce the signs and symptoms of the disease and improve your physical function.
Infliximab is usually prescribed in conjunction with methotrexate, a disease modifying anti-rheumatic drug (DMARD), as medical studies have shown that when both treatments are prescribed together, the two more effectively relieve the signs and the symptoms of RA.
How will infliximab affect my symptoms?
Infliximab often works rapidly and many patients begin to feel better as soon as 2 weeks after the first treatment. In general, you should feel the benefits of treatment within 12 weeks as inflammation in your joints reduces and the damage to your joints slows down. This makes everyday activities such as dressing, getting out of bed, eating, walking and washing easier to do.
Will there be any side-effects from infliximab?
Infliximab has been used to treat over 1.3 million patients worldwide with inflammatory conditions such as RA and it has been tested in many medical trials. Like all medicines, infliximab can have side-effects but these are mostly mild to moderate such as rashes or headaches and need not cause any concern. Some patients may find they are more prone to infections while being treated with infliximab. This is because infliximab works by suppressing the immune system. If you think you might have developed an infection, you should consult your doctor and they will decide if antibiotics are required.
How do I take infliximab?
Infliximab is a medicine that is given by IV infusion. This is a simple process, which takes place in hospital where you will be treated as an outpatient, or in some cases, in a doctor’s surgery. The process involves infliximab solution being infused via a drip into a vein in your arm over a two-hour period. After your first treatment you will be given the second infusion two weeks later and the third four weeks later. After that, in most cases you will only need an infusion once every eight weeks (just six times a year).
Most patients treated with infliximab are also treated with methotrexate, a disease modifying anti-rheumatic drug taken once weekly.
Can anyone take infliximab?
Infliximab is not suitable for people with moderate to severe heart failure, so prior to treatment you should discuss any heart conditions you may have with your doctor.
Can I take infliximab as well as other medications?
Infliximab is easily incorporated into your treatment programme and it is unlikely that you should need to come off any other medications you are taking for other conditions. However, it is important that you let your doctor know about all the medications you take so they can determine what is best for you.
References available on request
Professor Peter C. Taylor MA, PhD, FRCP, FRCPE Norman Collisson Professor of Musculoskeletal Sciences Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford Botnar Research Centre, Windmill Road Headington, Oxford, OX3 7LD.
Original article: 24/08/2004
Next review due: 08/01/2019