What is infliximab and why is it prescribed?
In rheumatoid arthritis and some other inflammatory conditions, too much of a protein called TNF is produced in the body, causing inflammation, pain and damage to the bones and joints. Anti-TNF drugs such as infliximab block the action of TNF and so reduce this inflammation. They're not painkillers, but can modify the disease and should start to improve your symptoms over a period of 2–12 weeks.
Infliximab can be prescribed by a consultant rheumatologist for:
There are national and local guidelines that determine when infliximab can be used and these vary depending on the condition.
Are there any reasons why infliximab won't be prescribed?
Infliximab won't be prescribed if:
- your arthritis isn't active
- you have an infection
- you haven't tried other drugs appropriate for your condition.
Doctors sometimes use a score known as DAS28 to work out how active your arthritis is. This counts how many of 28 specific joints are tender and swollen, and looks at inflammation levels in a blood test. You'll also be asked to score how well you feel on a scale of 0 to 10.
Your doctor may decide not to prescribe infliximab if you've had or have:
- repeated or serious infections
- multiple sclerosis (MS)
- a serious heart condition
- lung fibrosis (scarring of the lung tissue).
You'll have a chest x-ray and a test to check whether you’ve ever been exposed to tuberculosis (TB). You may need treatment for latent (asymptomatic) TB before starting infliximab.
You may also be checked for previous hepatitis infection, as infliximab may increase the risk of hepatitis being reactivated.
You'll probably have further checks while you're on infliximab to monitor its effects.
If infliximab isn't suitable for you your doctor will discuss other treatment options with you.