Chimeric (human constant part, murine variable part) monoclonal
antibody against TNFα.
Crohn's disease resistant to conventional treatment or with fistulae.
Rheumatoid arthritis unresponsive to methotrexate.
Has been tried in UC, but results not so impressive.
Method of administration
Slow intravenous infusion.
Single dose (severe Crohn's disease); three doses (Crohn's with fistulae);
Every 8/52 + methotrexate (rheumatoid arthritis).
Usually none. Hypersensitivity reactions (urticaria, dyspnoea, hypotension),
serum sickness, prone to infection; lupus-like syndrome.
Crohn's: reduces need for surgery by 15%. Clinical improvement seen in
up to 80% of patients.
£400 per 100 mg vial. 3 mg/kg for RhA is £800, 5 mg/kg for Crohn's is £1200 for
a 70 kg man.
ATTRACT trial: double blind placebo controlled trial. Infliximab in
patients with RhA despite methotrexate. Halts radiographic progression,
response maintained at 2 y.