Infliximab in the treatment of rheumatoid arthritis.
Infliximab was the first monoclonal antibody to human necrosis factor alpha (TNFalpha) developed for treating rheumatoid arthritis (RA). This chimeric antibody binds with high affinity to both soluble and trans-membrane TNF and is able to reduce synovial inflammation, bone resorption and cartilage degradation. The efficacy of infliximab has been observed in active RA despite treatment with multiple disease modifying anti-rheumatic drugs (DMARDs), and in early disease with no prior treatment by methotrexate (MTX). Infliximab has been shown to reduce joint inflammation and to slow radiographic progression, in both clinical and non-clinical responders. Recent data suggest that using infliximab early in RA treatment increases the percentage of clinical remission and allows infliximab discontinuation. The recommended dosage of 3 mg/kg could be increased up to 10 mg/kg with partial efficacy of the dose escalation. Antibodies to infliximab have been observed in 7% to 61% of patients and are associated with a low trough level of infliximab and secondary response failure. Their occurrence could be prevented by co-medication with MTX. The combination of DMARDs other than MTX with infliximab was found to be safe and efficacious. Infections, principally tuberculosis, are increased in treated patients, and the risk is greater at higher dose. Even if the treatment is generally safe and well tolerated, patients treated with infliximab should be closely monitored.
Perdriger
A
A
Service de Rhumatologie, CHU de Rennes, Hôpital Sud, France. aleth.perdriger@chu-rennes.fr
Medicine (Baltimore). 2007 Jul;86(4):242-251
17632266
N Engl J Med. 2003 Feb 13;348(7):601-8
12584368
JAMA. 2006 May 17;295(19):2275-85
16705109
Drugs. 2008;68(5):591-606
18370440
N Engl J Med. 2000 Nov 30;343(22):1594-602
11096166
J Infect Dis. 2008 Dec 15;198(12):1842-50
18954258
Semin Arthritis Rheum. 2005 Jun;34(6):819-36
15942917
Clin Pharmacokinet. 2007;46(8):645-60
17655372
Rheum Dis Clin North Am. 2004 May;30(2):329-47, vii
15172044
Clin Exp Rheumatol. 2008 Sep-Oct;26(5):834-40
19032816
Clin Infect Dis. 2005 Aug 1;41 Suppl 3:S199-203
15983900
Arthritis Rheum. 2007 Jun 15;57(5):756-61
17530674
Ann Rheum Dis. 2009 Jul;68(7):1153-8
18930988
Clin Exp Rheumatol. 2006 Nov-Dec;24(6 Suppl 43):S-77-82
17083767
J Rheumatol. 2009 Mar;36(3):635-41
19132789
Arthritis Rheum. 2004 Dec;50(12):4072-3
15593202
J Clin Immunol. 2008 Sep;28(5):445-55
18587633
Clin Ther. 2008 Nov;30(11):1939-55
19108784
Arthritis Rheum. 2007 Jul;56(7):2129-34
17599726
Arthritis Rheum. 2007 Dec;56(12):3919-27
18050189
Arthritis Res Ther. 2006;8(4):R112
16978395
Ann Rheum Dis. 2009 Jan;68(1):33-9
18230627
Arthritis Rheum. 2006 Apr;54(4):1075-86
16572442
Rheumatology (Oxford). 2007 Mar;46(3):529-32
17012439
Clin Gastroenterol Hepatol. 2006 Oct;4(10):1248-54
16931170
Muscle Nerve. 2008 Mar;37(3):281-92
18041052
Arthritis Rheum. 2004 Apr;50(4):1051-65
15077287
Arthritis Rheum. 1998 Sep;41(9):1552-63
9751087
Arthritis Rheum. 2005 Apr;52(4):1020-30
15818697
Arthritis Rheum. 2004 Apr 15;51(2):228-32
15077264
Pharmacol Ther. 2008 Feb;117(2):244-79
18155297
Arthritis Res Ther. 2007;9 Suppl 1:S1
17634140
Ann Rheum Dis. 2009 Nov;68(11):1739-45
19019895
Rheumatology (Oxford). 2002 Jun;41(6):631-7
12048288
Arthritis Rheum. 2002 Sep;46(9):2287-93
12355475
Clin Exp Rheumatol. 2008 Jan-Feb;26(1):18-23
18328142
Ann Rheum Dis. 2007 Nov;66 Suppl 3:iii2-22
17934088
Mod Rheumatol. 2008;18(5):460-4
18535759
Arthritis Rheum. 2006 Mar;54(3):692-701
16508929
Ann Rheum Dis. 2008 Mar;67(3):353-7
17644538
J Rheumatol. 2004 Aug;31(8):1538-45
15290732
Rheumatology (Oxford). 2007 Jan;46(1):146-9
16782732
Arthritis Rheum. 2005 Jan;52(1):61-72
15641091
Ann Rheum Dis. 2008 May;67(5):620-4
17720725
Arthritis Res Ther. 2006;8(4):R131
16869978
Drug Discov Today. 2007 Jul;12(13-14):548-52
17631249
Clin Exp Rheumatol. 2006 Jan-Feb;24(1):38-44
16539817
Arthritis Rheum. 2002 Dec;46(12):3151-8
12483718
Arthritis Rheum. 2005 Nov;52(11):3403-12
16255017
Cytokine Growth Factor Rev. 2004 Oct;15(5):353-66
15450251
Am J Med. 2007 Dec;120(12):e21; author reply e23
18060907
Autoimmun Rev. 2008 Dec;8(2):147-52
18706526
Ann Rheum Dis. 2007 Sep;66(9):1233-8
17392352
Arthritis Rheum. 2006 Mar;54(3):702-10
16508926
N Engl J Med. 2001 Mar 22;344(12):907-16
11259725
Arthritis Res Ther. 2007;9(1):202
17306038
Arthritis Rheum. 2004 Jun;50(6):1740-51
15188349
J Rheumatol. 2006 May;33(5):865-9
16652418
J Dtsch Dermatol Ges. 2009 Mar;7(3):191-4
19192165
Arthritis Rheum. 2008 Nov;58(11):3330-9
18975323
J Exp Med. 2004 Aug 2;200(3):277-85
15280421
Ann Rheum Dis. 2009 Jun;68(6):823-7
18593759
Arthritis Rheum. 2006 Jun;54(6):1786-94
16736520
Rheumatology (Oxford). 2007 Jul;46(7):1153-6
17478470
N Engl J Med. 2001 Oct 11;345(15):1098-104
11596589
Br J Dermatol. 2008 Sep;159(3):527-36
18627374
Ann Rheum Dis. 2007 Nov;66 Suppl 3:iii45-8
17934095
Best Pract Res Clin Rheumatol. 2006 Oct;20(5):897-913
16980213
Arthritis Rheum. 2004 Nov;50(11):3432-43
15529377
Arthritis Res Ther. 2006;8(4):R114
16859506
Congest Heart Fail. 2002 Sep-Oct;8(5):275-9
12368591
Arthritis Rheum. 2007 Mar;56(3):710-3
17328040
Blood. 2006 Jul 1;108(1):253-61
16537805
Manag Care Interface. 2005 Apr;18(4):21-7
15889759
Lancet Infect Dis. 2003 Mar;3(3):148-55
12614731
Arthritis Rheum. 2006 Jan;54(1):47-53
16385521
Lancet. 1999 Dec 4;354(9194):1932-9
10622295
Arthritis Rheum. 2005 Nov;52(11):3381-90
16258899
Rheumatology (Oxford). 2003 May;42(5):617-21
12709536
Nat Clin Pract Rheumatol. 2006 Nov;2(11):602-10
17075599
Arthritis Rheum. 2007 Sep;56(9):2886-95
17729297
Drugs. 2000 Jun;59(6):1341-59
10882166
Joint Bone Spine. 2007 Jan;74(1):56-9
17182267
Expert Opin Pharmacother. 2007 Sep;8(13):2089-107
17714062
Rheum Dis Clin North Am. 2004 May;30(2):237-55, v
15172038
Annu Rev Immunol. 1996;14:397-440
8717520
Arthritis Rheum. 2005 Jan;52(1):27-35
15641102
Arthritis Rheum. 2001 Sep;44(9):1977-83
11592357
Gut. 2007 Sep;56(9):1226-31
17229796