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Infliximab
Infliximab is combined with methotrexate in people who do not respond sufficiently to methotrexate alone. As with etanercept, infliximab neutralizes the activity of tumor necrosis factor, thereby reducing some RA symptoms.
Infliximab is administered by intravenous infusions, typically in an outpatient setting.
A recent phase II trial of infliximab for heart failure found that people taking the drug had an increased rate of mortality and hospitalization for worsening heart failure. In response, the manufacturer notified doctors that people with heart failure should not begin using the drug and that infliximab therapy should be re-evaluated for people with heart failure and some other heart conditions.
As with etanercept, people taking infliximab must be monitored by their doctor for neurological symptoms such as confusion, numbness, changes in vision, and difficulty walking. Also, as with etanercept, people taking infliximab may develop serious infections, and people who suffer from chronic infections or take immunosuppressive therapy should consider other RA therapies. Infliximab also has been linked to the blood disorders leukopenia, neutropenia, thrombocytopenia, and pancytopenia, as well as lymphoma. Because infliximab can cause latent tuberculosis to develop into full-blown tuberculosis, patients should receive a tuberculin skin test before beginning therapy.
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