Joint venture
(see 1999 ACR Meeting Highlights) The safety and efficacy of infliximab given in conjunction with methotrxate were assessed in a multicenter, randomized, double-blind, placebo-controlled study of 428 patients. joint venture Bladder pain. Patients with rheumatoid arthritis of 6 months duration or more who were active despite methotrexate therapy were randomized to one of five treatment groups: placebo; infliximab 3 mg/kg every 4 or 8 weeks; infliximab 10 mg/kg every 4 or 8 weeks, intravenously. Patients in all five groups received methotrexate >12. 5 mg/week. joint venture Palindromic rheumatism arthritis. Fifty-nine percent of patients receiving the 10 mg/kg dose of infliximab achieved ACR 20 response, as did >42% of patients receiving the 3 mg/kg dose compared to only 17% in the placebo (methotrexate only) group. Radiograpic changes in the study above were also monitored. Placebo treated patients exhibited radiographic progression at an average rate of 4. joint venture Causes-knee-pain. 0 Sharp units per year while the four infliximab groups progressed at average rates ranging from -0. 5 to 0. 5. These data confirm that the combination of infliximab/methotrexate has a significant disease modifying effect compared to methotrexate alone. Mechanism: Infliximab is expected to bind TNF-a in the circulation, preventing its interaction with TNF-a receptors on the surface of inflammatory cells, and eventually clearing TNF-a from the circulation. (slide) Like etanercept, infliximab inhibits the activity of TNF. Dosing: The recommended dose of infliximab is 3 mg/kg given as an intravenous infusion followed with additional 3 mg/kg doses at 2 and 6 weeks after the first infusion, then every 8 weeks thereafter. Infliximab should be given in combination with methotrexate. Side effects: Since infliximab contains 25% mouse sequence, a major concern is the development of human anti-chimeric antibodies (HACA) which would block infliximab from binding TNF-a. HACA would be expected after repeated administration and would result in diminished therapeutic response over time. Methotrexate appears to diminish HACA. Monoclonal antibody therapy has also been associated with "cytokine release syndrome" a clinical syndrome of fever, chills headache associated with the infusion of the antibody. The frequency of this syndrome has diminished with the use of chimeric and humanized antibodies that contain less mouse sequence and slower infusion rates. Infliximab is administered by IV infusion over 2 hours to prevent these symptoms.
Joint venture
Pain || Middle-back-pain || Arthritis-and-food || Arthritis-cream