Infliximab

From Ganfyd

A chimeric monoclonal IgG₁ antibody directed against tumour necrosis factor alpha (TNF-α). Inflixmab is used to treat diseases in which TNF-α is thought to be a significant cytokine mediator of inflammation. By neutralising the biological effect of TNF-α, infliximab is thought to attenuate the imbalance of inflammation. It has been used in conditions that include:

• Crohn's disease, particularly fistulating disease.^[1][2]
• Rheumatoid arthritis
• Ulcerative colitis^[3]
• Psoriasis, see ^[4]

As it is a mouse/human chimera, infliximab is immunogenic and can induce antibodies to itself. This can adversely affect its subsequent administration and efficacy. An human recombinant alternative called Adalimumab is thought to avoid these problems.

Anti-TNF antibody Side-effects

• Hypersensivity
• Fever
• Nausea
• Abdominal pain
• Heart failure
• Headache
• Pruritis
• Depression
• SLE like syndrome
• Blood dyscrasias

Latent tuberculosis should be excluded[5] Withdrawal of the anti-TNF therapy in a secondary lung malignancy that expressed TNF receptors lead to tumour regression[6]

• Infections, including severe sepsis (odds ratio for serious infection 2.0 (95% CI, 1.3-3.1), number needed to harm 59 (95% CI, 39-125) within a treatment period of 3 to 12 months).
• Malignancy (odds ratio for malignancy 3.3 (95% CI, 1.2-9.1) number needed to harm 154 (95% CI, 91-500) for 1 additional malignancy within period of 6 to 12 months), including an association with hepatosplenic T-cell lymphoma in patients also on mercaptopurines.

References to side-effects^{[7] [8]}

References