title: [Suspected cases of severe side effects after infliximab (Remicade) in Germany].
abstract: BACKGROUND
  Remicade is a chimeric, human-murine, monoclonal antibody. Remicade was approved in the EU in August 1999 for the treatment of active refractory Crohn's disease, and for treating fistulas in subjects with refractory Crohn's disease, and in December 2000 for preventing disease progression in subjects with methotrexate-resistant rheumatoid arthritis. In May 2003, infliximab was approved in the EU for the treatment of ankylosing spondylitis in patients with severe symptoms and elevated serologic parameters of inflammation, who have been refractory to standard treatment.
  
  
  RESULTS
  On the basis of the so-called spontaneous capture, the Paul Ehrlich Institute was notified of 44 adverse drug reactions leading to the death of the patient after the application of infliximab in Germany. 18 of these patients had rheumatoid arthritis, eight Crohn's disease, 13 graft-versus-host disease, and five other diseases. 24 of those patients had sepsis or serious infections. According to the manufacturer, 20,000 patients have been treated in Germany with infliximab.
  
  
  CONCLUSIONS
  We discuss, in this article, the question of causal relation with the medication and make recommendations for the safe use of infliximab.
authors.affiliation: Klinik für allgemeine Innere Medizin, Gastroenterologie, Hepatologie und internistische Onkologie, Krankenhaus Bad Cannstatt, Stuttgart.
authors.forename: Tilo
authors.initials: T
authors.lastname: Andus
authors.forename: Eduard F
authors.initials: EF
authors.lastname: Stange
authors.forename: Dieter
authors.initials: D
authors.lastname: Höffler
authors.forename: Brigitte
authors.initials: B
authors.lastname: Keller-Stanislawski
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D003627:Data Interpretation, Statistical; D017277:Drug Approval / Q000331:legislation & jurisprudence; D005858:Germany; D006801:Humans; D000069285:Infliximab; D007412:Intestinal Fistula / Q000188:drug therapy; D018570:Risk Assessment; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab