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Infliximab

Also read: Biologicals , TNF-alpha Blocker
Infliximab is a genetically engineered monoclonal antibody (because the antibodies were produced from one cell that was grown into a clone of identical cells, it is called a monoclonal antibody) to TNF-a. As it is a combination of mouse and human antibody, it is called a chimeric monoclonal antibody.

Mechanism of Action:

See TNF-alphablocker It reduces levels of interleukin-6 and chemokines, including macrophage chemoattractant protein-1, as well as adhesion molecules, such as intercellular adhesion molecule-1.

Dosage and pharmacokinetics:

The infliximab is administered as intravenous infusion in 5 to 10 mg/kg doses12.The doses can be increased up to 20mg/kg. The half life of infliximab is about 10 days and biological effect of the drug persists for up to 60 days.

• Infliximab was developed by Junming Le and Jan Vilcek at New York University School of Medicine and developed by Centocor, a biotechnology company later purchased by Johnson & Johnson.
• It has a half life of 10 days.
• Infliximab is approved by Food and Drug Administration (FDA) for the treatment of rheumatoid arthitis, Crohn’s disease, ankylosing spondylitis and psoriatic arthritis.
• Infliximab was approved for the treatment of uveitis in patients with Behcet disease by National Health Insurance of Japan in 2007


Uses:

Infliximab is found to effective as a short term immunosuppressive agent in noninfectious uveitis with relatively low side effects.However repeated infusions are often needed to prevent recurrences.Infliximab has been found to be very effective in the treatmet of behcet’s disease,even in recalcitrant cases.The response to the  infliximab therapy has been found to be rapid in onset and also found to be effective in controlling the extraocular manifestations  of the disease.Reports suggest that infliximab therapy seemed to be well tolerated in children with chronic uveitis.However in these paediatric cases  greter doses of the drug is needed.Infliximab has been found useful in the treatment of childhood uveitis also.Infliximab has been used to treat macular oedema secondary to uveitis and diabetic retinopathy which showed reduction of macular thickness and improved vision .There are reports of treatment of posterior segment neovascularisation with Infliximab.

Side effects:

There is greater chance of reactivation of granulomatous infection (e.g. tuberculosis) in patient taking Infliximab. So, latent tuberculosis must be excluded before the administration of infliximab therapy using specific tests such as interferon gamma assays. Other serious side effects reported are pulmonary embolism, congestive heart failure, lupus like reaction and vitreous hemorrhage. There are chances of development of antinuclear antibodies in patients receiving multiple infusions . For this reason some advocates use of low-dose methotrexate or other immunosuppressive agent along with Infliximab.However there is also evidence which suggest that infliximab works synergistically with methotrexate.

Statutory Warning

Materials / Informations provided here are for educational purpose only ; and not to be used for medical advice, diagnosis or treatment