Infliximab treatment for rheumatic disease: clinical and radiological efficacy

Abstract

Infliximab is a chimeric anti-tumour necrosis factor alpha (TNFalpha) monoclonal antibody with high affinity and binding specificity for human TNFalpha. Results from several well designed, controlled clinical trials show repeated infusions of infliximab with concomitant methotrexate (MTX) treatment can reduce the signs and symptoms of rheumatoid arthritis (RA). This combination of infliximab and MTX also slows the radiological progression of joint damage, decreases functional disability, and improves qualify of life. These remarkably positive results have led to the investigation of infliximab treatment for other rheumatic diseases. Recently, controlled studies have shown treatment with infliximab can benefit patients with active spondyloarthropathy. TNFalpha has fast become an important therapeutic target in rheumatology.

Figure 1

Clinical improvement of ankylosing spondylitis with infliximab treatment. Results from a randomised, double blind, placebo controlled trial. Eligible patients were treated with either infusions of placebo or infliximab 5 mg/kg at week 0, 2, and 6. The primary outcomes were determined at week 12. See text for description of the BASDAI outcome measure. Statistical differences in response rates between treatment groups were determined by Fisher's exact test. Data from Braun et al.¹⁶