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Infliximab

Infliximab (INN; trade name Remicade) is a monoclonal antibody against tumour necrosis factor alpha (TNFα). It is used to treat autoimmune diseases. Remicade is marketed by Janssen Biotech, Inc. (formerly Centocor Biotech, Inc.) in the USA, Mitsubishi Tanabe Pharma in Japan, Xian Janssen in China, and Schering-Plough (now part of Merck & Co) elsewhere.

Infliximab was approved by the U.S. Food and Drug Administration (FDA) for the treatment of psoriasis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis and ulcerative colitis. Infliximab won its initial approval by the FDA for the treatment of Crohn's disease in August 1998.

Infliximab works by binding to tumour necrosis factor alpha. TNFα is a chemical messenger (cytokine) and a key part of the autoimmune reaction. Originally, it was assumed that infliximab works by blocking the action of TNFα by preventing it from binding to its receptor in the cell, and for the action of infliximab in rheumatoid arthritis. This still seems to be true. However, another TNFα-neutralizing medication, etanercept (Enbrel), is worse than a placebo in Crohn's disease and thus TNFα-neutralisation is not responsible for its powerful action in the latter disease. As infliximab causes programmed cell death of TNFα-expressing activated T lymphocytes, an important cell type mediating inflammation, but etanercept does not have this activity, now it is generally assumed that resolution of activated T cells by infliximab explains its efficacy in Crohn's disease.

Infliximab is an artificial antibody. It was originally developed in mice, as a mouse antibody. Because humans have immune reactions to mouse proteins, it was later developed into a human (humanized) antibody. Because the antibodies were produced from one cell that was grown into a clone of identical cells, it is called a monoclonal antibody. Because it is a combination of mouse and human antibody, it is called a chimeric monoclonal antibody.

Infliximab was developed by Junming Le and Jan Vilcek at New York University School of Medicine and developed by Centocor, (now Jannsen Biotech, Inc.)

Infliximab can cost $19,000 to $22,000 a year per patient wholesale, according to Centocor. Infliximab is typically covered under major medical insurance (rather than prescription drug insurance).

Other monoclonal antibodies targeting TNFα are golimumab (Simponi), adalimumab (Humira), and certolizumab pegol (Cimzia). Etanercept also binds and inhibits the action of TNFα but is not a monoclonal antibody (it is instead a fusion of TNF-receptor and an antibody constant region).

Infliximab is administered by intravenous infusion, typically at 6-8 week intervals, and at a clinic or hospital. It cannot be administered orally, because the digestive system would destroy the drug.

This text uses material from Wikipedia and is available under the GNU Free Documentation License.


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