Indications
Infliximab is used in adults with moderately to severely active Crohn's disease who have had an inadequate response to conventional therapy. It reduces signs and symptoms and helps bring about and maintain clinical remission. In adults with fistulizing disease, it reduces the number of draining enterocutaneous and rectovaginal fistulas and helps keep the fistulas closed. In pediatric patients with moderately to severely active Crohn's disease who have had an inadequate response to conventional therapy, it reduces signs and symptoms and helps bring about and maintain clinical remission. For ulcerative colitis in adults with moderately to severely active disease who have had an inadequate response to conventional therapy, it reduces signs and symptoms, brings about and maintains clinical remission and mucosal healing, and eliminates corticosteroid use. Pediatric patients with moderately to severely active ulcerative colitis who have had an inadequate response to conventional therapy can use it to reduce signs and symptoms and to bring about and maintain clinical remission. In rheumatoid arthritis, infliximab is given together with methotrexate in patients with moderately to severely active disease. It reduces signs and symptoms, inhibits the progression of structural damage and improves physical function. In ankylosing spondylitis, it reduces signs and symptoms in patients with active disease. In psoriatic arthritis, it reduces signs and symptoms of active arthritis, inhibits the progression of structural damage and improves physical function. It is also used to treat adults with chronic severe plaque psoriasis (that is, extensive and/or disabling) who are candidates for systemic therapy, when other systemic therapies are medically less appropriate.
⚠️ Always consult a registered physician before taking any medicine.
Pharmacology
Infliximab works by binding with high affinity to both the soluble and the transmembrane forms of TNFα. This stops TNFα from attaching to its receptors, so its biological activity is neutralized. Infliximab does not neutralize TNFα (lymphotoxin-α), which is a related cytokine that uses the same receptors as TNFα.
TNFα has several biological activities. These include inducing pro inflammatory cytokines such as interleukins (IL) 1 and 6, and increasing leukocyte migration by raising endothelial layer permeability and the expression of adhesion molecules by endothelial cells and leukocytes. TNFα also activates the functional activity of neutrophils and eosinophils. It induces acute phase reactants and other liver proteins, as well as tissue degrading enzymes produced by synoviocytes and/or chondrocytes.
Cells that express transmembrane TNFα and have infliximab bound to them can be lysed in vitro or in vivo. In a wide variety of in vitro bioassays using human fibroblasts, endothelial cells, neutrophils, B and T lymphocytes and epithelial cells, infliximab inhibits the functional activity of TNFα. How these biological response markers relate to the way infliximab produces its clinical effects is unknown.
In animal studies, anti-TNFα antibodies reduce disease activity in the cotton-top tamarin colitis model, and decrease synovitis and joint erosions in a murine model of collagen-induced arthritis. Infliximab prevents disease in transgenic mice that develop polyarthritis because of constitutive expression of human TNFα. When it is given after the disease has started, eroded joints are able to heal.
Pregnancy & Breastfeeding
Infliximab is listed as Pregnancy Category B. Doctors don't know whether Infliximab can harm an unborn baby when it is given to a pregnant woman, or whether it can affect the ability to have children.
It is also not known whether Infliximab passes into human milk, or whether the baby's body absorbs it after swallowing. Many drugs and immunoglobulins do pass into human milk, and Infliximab could cause adverse reactions in nursing infants. So women should not breast-feed their infants while taking Infliximab.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Dosage Reference
⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.