INFLIXIMAB INFUSION FOR CROHN'S DISEASE

WHAT IS INFLIXIMAB?

Infliximab (also called Remicade®) is a medication used in adults to reduce the signs and symptoms and induce and maintain remission in those individuals with moderate to severe active Crohn's disease. It is used when other therapies have not worked but it is not a cure for Crohn's disease.  It is also used in other autoimmune diseases including Rheumatoid Arthritis, Ankylosing Spondylitis, Psoriatic Arthritis and Plaque Psoriasis.

HOW DOES IT WORK?

Infliximab works by blocking the action of a protein in your body called TNF-alpha (tumor necrosis factor-alpha).  The body's own immune system makes TNF-alpha and people who have diseases like Crohn's have too much TNF-alpha.  This causes the immune system to attack normal healthy parts of the body, like the bowel and cause disease.  Infliximab is designed to block the damage that is caused by having too much TNF-alpha in the body and thus decreasing the symptoms of the disease.

HOW IS IT GIVEN?

Infliximab is given via an IV infusion.  This requires a day admission to hospital for at least 4 hours.  The infusion is given over several hours and you are required to stay for further monitoring to make sure that there are no side effects from the infusion.  It is a good idea to bring along items like books and magazines to keep yourself busy during this time.  A second infusion (dose) of infliximab is often given X weeks after the first depending on the disease being treated.

WHAT ARE THE SIDE EFFECTS?

During the infusion, some of the more common side effects include:

  • fever or chills
  • itch
  • chest pain
  • shortness of breath
  • changes in blood pressure

Because of these side effects, patients are monitored during the infusion.   It is also common for a steroid or anti-histamine to be given as a pre-medication before the treatment to decrease the chance of the side effects occurring.

More rare side effects during an infliximab infusion are:

  • allergic reaction with symptoms including itchiness, red skin or rash and difficulty breathing
  • inflammation to the nerve of the eye causing changes in vision or sensation

A very rare side effect during an infliximab infusion:

  • 'Drug induced' Lupus which includes symptoms of rash, fever and increased joint pain

Many of the side effect will actually disapper when the infliximab infusion has been ceased.

 

Infliximab can cause some more serious side effects including:

  • Increase risk of infections including tuberculosis (TB) and infections caused by viruses, fungi and bacteria.  This is due to the fact the infliximab is a drug that acts on your immune system lowering the ability of your immune system to fight infections.  Please inform your doctor if you have an infection, have any signs of an infection or are recovering from an infection.
  • Increase risk of unusual cancers and lymphomas.  Patients who have been treated for longer periods of time and those with very active Crohn's disease are more likely to develop lymphomas.  Some patients with Crohn's disease or ulcerative colitis who have been treated with infliximab have developed a rare type of cancer called Hepatosplenic T-cell Lymphoma.  This is more common is teenagers or young male adults. These patients had also been treated with the drugs azathiprine (Imuran) or 6-mercaptopurine.

 
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