Infliximab/Remicade – Schering-Plough (www.remicade.com)

How does it work?

Remicade is an anti-TNF antibody that binds to and inhibits human TNF alpha – it suppresses part of the immune system and modifies the processes of inflammation, whether that be in the joint, gut or skin.

How is it administered?

Remicade is used with MTX in the treatment of psoriatic arthritis and is administered by IV drip in hospital at the rate of 3mg/kg over a period of two hours and at intervals of 0, 2, 6 and 8 weeks.

What are the side effects?

Common side effects at trial level and licensed level include: breathing difficulties, dizziness, rash, headaches, chills, joint and muscle aches, hypo/hyper tensions, fatigue and disturbance in liver function and gut.

There is a higher risk of opportunistic infection, particularly chest and TB infection. Pregnancy and breastfeeding are contra-indicated. Due to Remicade’s long half-life, monitoring of these potential problems should continue for at least 6 months after cease of use.

However, these are short term side effects. The long term effects cannot be calculated until the drug has been widely used for many years across a large number of patients

What are the results?

In a psoriasis study for Remicade with MTX, 249 patients were given two different doses (3-5mg/kg) – 88% saw up to 75% improvement in their symptoms with the effects of 3 infusions lasting up to 6 months. In a psoriatic arthritis study, 102 people had an up to 20% improvement of their severity scores.