Infliximab for ankylosing spondylitis

Examples

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Brand Name	Generic 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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The most common side effect of TNF antagonists, such as infliximab, is an allergic reaction to the infusion (medicine given in a vein—intravenously, or IV). If you have a reaction to the infusion, it will happen right away, either during the infusion or within 1 to 2 hours after the infusion. Your doctor may give you medicines to prevent or stop the reaction.

Symptoms of an infusion site reaction include:

• Fever.
• Chills.
• Chest pain.
• Shortness of breath.
• Itching (pruritus).
• Headache.
• Nausea.
• Heat and redness (flushing) in the face.
• Rash.
• Fatigue.
• Dizziness.

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

• An increased risk of a serious infection. TNF antagonists affect your body's ability to fight all infections. So if you get a fever, cold, or the flu while you are taking this medicine, let your doctor know right away.
• An increased risk of blood or nervous system disorders. Call your doctor 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).
• A possible increased risk of lymphoma (a type of blood cancer). It is not clear whether this increase is because of the drug or because people with this disease may already have a higher risk. There have been reports of a rare kind of lymphoma, occurring mostly in children and teens taking TNF antagonists, that often results in death.
• An increased risk of liver injuries. Call your doctor if your skin starts to look yellow, if you are very tired, or if you have a fever or dark brown urine.

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, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 18, 2007