Infliximab for ankylosing spondylitis

Examples

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Brand Name	Chemical Name
Remicade	infliximab

Infliximab is given by injection into a vein (intravenously) every 4 to 8 weeks. It can be used to treat ankylosing spondylitis, rheumatoid arthritis, or inflammatory bowel disease (ulcerative colitis or Crohn's disease).

How It Works

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Infliximab can help reduce the symptoms and slow the progression of ankylosing spondylitis. Infliximab is an immunosuppressive medicine, which means that it reduces the activity in the body's immune system. Infliximab reduces the effects of tumor necrosis factor, a protein that increases inflammation.

Why It Is Used

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Infliximab is a newer medicine that provides relief from pain and inflammation and, in doing so, may slow the progression of ankylosing spondylitis.

How Well It Works

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Infliximab can reduce symptoms of ankylosing spondylitis, such as pain and stiffness, and improve function and quality of life in people with this disease.¹

Side Effects

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Infliximab is only given in a vein (intravenously). Side effects include:

• Chest pain.
• Nausea.
• Fever.
• Chills.
• Itching (pruritus).
• Facial flushing.
• Headache.
• Rash.
• Fatigue.
• Dizziness.

Warnings about serious side effects of infliximab (Remicade) have been issued. The U.S. Food and Drug Administration (FDA) and the drug’s manufacturer have warned about:

• An increased risk of blood or nervous system disorders, some potentially fatal. Contact your health professional if you have symptoms of blood disorders (such as bruising or bleeding) or symptoms of nervous system problems (such as numbness, weakness, tingling, or vision problems).
• An increased risk of a serious infection (such as tuberculosis). If you have had tuberculosis (TB) or know someone who has, tell your doctor. Infliximab also affects your body's ability to fight all infections, so if you are taking the drug and get a fever, cold, or flu, let your doctor know right away.
• An increased risk of liver injuries, some potentially fatal. Call your doctor if your skin starts to look yellow, if you have dark brown urine or a fever, or if you are very tired.
• A possible increased risk of developing lymphoma (a type of blood cancer). Studies are under way to try to understand the relationship between drugs like infliximab and lymphoma risk.
• A possible reaction to the infusion. Some people will have hives, trouble breathing, or low blood pressure after an infusion of infliximab. These reactions most often occur right away, and your doctor may give you medicines to prevent or stop the reaction.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Talk to your doctor before taking infliximab if you are breast-feeding, pregnant, or thinking about becoming pregnant.

A baseline complete blood count (CBC) and periodic blood counts are recommended if you take this medicine on an ongoing basis.

Because infliximab is a new medicine, long-term side effects are not completely known.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Braun J, et al. (2002). Treatment of active ankylosing spondylitis with infliximab: A randomised controlled multicentre trial. Lancet, 359(9313): 1187–1193.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Tracy Landauer
Associate Editor	Pat Truman
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 18, 2007