Infliximab (Remicade)

[Guest guest]

Infliximab was approved by the Food and Drug Administration for the

treatment of rheumatoid arthritis in November. What is the mechanism by

which this drug works, and what is a similar drug in this class?

http://rheumatology.medscape.com/Medscape/features/question/1999/12.99/q710.html

The mechanism by which the drug works is to block the inflammatory

cytokine tumor necrosis factor (TNF)-alpha. TNF-alpha stimulates the

release of pro-inflammatory cytokines, including interleukin (IL)-6,

IL-8, and IL-1B. Inhibiting the production of TNF-alpha restricts the

release of these pro-inflammatory cytokines, and the pain of rheumatoid

arthritis is temporarily relieved.

Along with etanercept, the TNF inhibitors gained attention at the recent

American College of Rheumatology meeting for the mounting evidence for

the safety and efficacy of these treatment methods.[1-5] However, the

results are still preliminary in many cases, and questions remain about

safety for long-term treatment and increased susceptibility to

infection.

References

1.Kavanaugh A, Schaible T, DeWoody K, Marsters P, Dittrich K,

Harriman G. Long-term follow-up of patients treated with infliximab

(anti-TNF-alpha antibody) in clinical trials. Presented at the

American College of Rheumatology 63rd Annual Scientific Meeting;

November 12-17, 1999; Boston, Mass. Abstract 1979.

2.Lipsky P, St. Clair W, Furst D, for the ATTRACT Investigators.

54-week clinical and radiographic results from the ATTRACT trial: a

phase III study of infliximab (Remicade) in patients with active RA

despite methotrexate. Presented at the American College of

Rheumatology 63rd Annual Scientific Meeting; November 12-17,

1999; Boston, Mass. Abstract 1980.

3.Maini R, Lipsky P, Kalden J, et al. A double blind, placebo

controlled trial of the anti-TNF-alpha monoclonal antibody

infliximab

in RA patients with active disease despite concurrent methotrexate.

Lancet. In press.

4.Moreland LM, Cohen SB, Baumgartner S, Schiff M, Tindall EA,

Burge DJ. Long-term use of etanercept in patients with

DMARD-refractory rheumatoid arthritis. Presented at the American

College of Rheumatology 63rd Annual Scientific Meeting;

November 12-17, 1999; Boston, Mass. Abstract 1981.

5.Weinblatt ME, Kremer JM, Lange M, Burge DJ. Long-term safety

and efficacy of combination therapy with methotrexate (MTX) and

etanercept (Enbrel). Presented at the American College of

Rheumatology 63rd Annual Scientific Meeting; November 12-17,

1999; Boston, Mass. Abstract 1982.

Source: Rheumatoid Arthritis: TNF - Blockade.