Infliximab (Remicade®) is a powerful drug used to treat auto-immune disorders like Crohn's disease and rheumatoid arthritis. Infliximab is known as a "chimeric monoclonal antibody" (the term "chimeric" refers to the use of both mouse and human components of the drug i.e. mouse binding VK and VH domains and human constant Fc domains). The drug reduces the amount of active TNF-α (tumour necrosis factor alpha) in the body by binding to it and preventing it from signaling the receptors for TNF-α on the surface of cells. more...
TNF-α is one of the key cytokines that triggers and sustains the inflammation response. Remicade was invented at New York University School of Medicine and developed by Centocor, a pharmaceutical company owned by Johnson & Johnson.
It is made up of part-human part mouse protein, and is administered by intravenous infusion (usually on an outpatient basis). Before infliximab is administered a test for tuberculosis must be performed, as infliximab has been shown to increase the risk of reactivation of latent tuberculosis. Other potential side effects include skin rash, fever, tiredness and difficulty breathing.
Since the drug's approval and wide-spread use, significant concerns about the safety of infliximab have been raised. After a number of studies and reports of significant adverse reactions in patients receiving infliximab therapy (including serious and sometimes fatal blood disorders, infections, lymphoma and other cancers, serious liver injury, and central nervous system disorders), the U.S. Food and Drug Administration issued a warning to doctors instructing them to screen and monitor potential patients more carefully.
Case studies have been done into other uses of infliximab, such as to treat skin diseases. Remicade (infliximab) has been approved for treating ankylosing spondylitis, Crohn's disease, psoriatic arthritis, psoriasis (EU), rheumatoid arthritis, and ulcerative colitis.
There have been numerous case reports of the efficacy of infliximab in various inflammatory skin conditions diseases; psoriasis, in which increased TNFα has been demonstrated, is the most promising indication (Gupta and Skinner, 2004).
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