Why we use Remicade (infliximab) plus methotrexate

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Although you are not required to use methotrexate (MTX) if you are going

to use Remicade, it is strongly recommended.

In the early trials of Remicade, the biologic was given to study

participants as monotherapy. Infusion reactions and formation of

antibodies to Remicade were common; efficacy was impaired. To prevent

the formation of the antibodies that were working against Remicade, it

was decided to use MTX along with Remicade so that the MTX could

suppress the immune system antibody response. It worked. The results

were much better with MTX added.

MTX is the most effective traditional DMARD that we have decades of

experience with. It makes sense to use it as a first choice with

Remicade.

Since those early trials, we have much data on the Remicade plus MTX

combination. Use of MTX reduces the likelihood of the occurrence of

infusion reactions and the formation of antibodies to Remicade and

increases the chances for a longer duration of efficacy for each

infusion. It has also been proposed by some that Remicade and MTX work

together synergistically (the overall effect is greater than simply

additive).

While it is acceptable to use other DMARDs with Remicade should it not

be possible to use MTX, there isn't as much data on other combinations;

however, it's quite likely a superior strategy than using Remicade

alone.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org