INFLIKSIMAB (Infliximab)

     Synonym : Remikeyd, Remicade

     Description : Himernye myshino- human IgG1 monoclonal antibodies, consisting of variabelnoy (Fv) of vysokoaffinnyh neutralizing monoclonal mouse antibody to opuholi- necrosis factor alpha and fragment molecules IgGlk rights.

     Pharmacology : The drugs act-ummunomodulating.

For high affinnostyu to opuholi- necrosis factor alpha (FNO- alpha), is sustained as a soluble complex, and membran- associated with the human form of alpha FNO-, reducing its functional activity. It is expected that the reduction of alpha FNO- sinovialnyh can modulate apoptosis in cells and inhibit virus hyperplasia. The concentration decreases (links and ingibiruet synthesis) interleykina? 1 (IL? 1), interleykina? 6 (IL? 6), interleykina? 8 (IL? 8), monotsitarnogo hemoatraktantnogo protein? 1, nitric oxide, metalloproteinaz (kollagenaza, stromelizin) , and other inducers inflammation and tissue destruction and the level of soluble adhesion molecules ICAM-? 1 and E-selektina reflecting the activation of vascular endoteliya (E. L. Nasonov, 2000).

Effectiveness infliksimaba with seronegative spondiloartropatiyah (ancylosing spondylitis, poliartikulyarny psoriatichesky arthritis) and diseases Krona (E. L. Nasonov, 2001).

Eliminates the body for 6 months.

     Application : Rheumatoid arthritis (active form), with the ineffectiveness of previous therapy, including methotrexate (combined therapy with methotrexate); Disease Krona (active form), including with the formation of fistulas, with heavy and inefficiency during corticosteroid therapy and / or immunosuppressants.

     Contraindications : Giperchuvstvitelnost (including from other mice protein), sepsis, clinically expressed Abscess or contagious disease, pregnancy, breast-feeding.

     Restrictions apply to : Children's age (safety and efficacy of the children and adolescents under the age of 18 are not identified).

     Application of pregnancy and breastfeeding : Protivopokazano pregnancy. At the time of treatment should stop breastfeeding.

     Side Effects : From the nervous system and sensory organs : 1-10%, headache, dizziness; 0,1-1% - depression, psychosis, anxiety, amnesia, apathy, anxiety, drowsiness, conjunctivitis, keratokonyunktivit, endoftalmit, swelling periorbitalny .

From the cardiovascular system and blood (blood, hemostasis) : 0,1-10% tides petehii, ekhimoz / bruise hyper / hypotension, aetiology, heart arrhythmia, causes receptacles violation of peripheral blood throm, monster ; 0,1-1% anaemia, leyko-, limfo-, stoichiometric, thrombocytopenia, limfotsitoz, lymphadenopathy.

From the respiratory system : 0,1-10% sinusitis, nasal bleeding, infections of the upper respiratory tract, bronchitis, pneumonia, pleurisy, dizziness, swelling of the lungs.

For part of the digestive tract : 0,1-10 - Heilit, nausea, diarrhoea or constipation, neuralgia, stomach ulcers physically, divertikulit, cholecystitis, the effects on the liver.

From the urogenital system : 0,1-1%, urinary tract infection (medicine, etc.), vaginitis, swelling.

For the skin : 0,1-10% sweating, dry skin, hyperkeratosis, a violation of skin pigmentation, cyanosis, fungal dermatitis (onihomikoz, eczema), seborrhea, birthmarks, warts, abrasions, Alopecia, bulleznaya rashes.

Allergic reactions : 0,1-10% rashes, itching, urticaria, bronchospasm and other allergic symptoms.

Other : 0,1-10-development infections (influenza, herpes, fever, Abscess, cellulitis, pneumonia, bacterial and fungal diseases), fatigue, and Tank syndrome (including pain in the chest, abdomen); 0 ,1-1% mialgiya, arthralgia, education IgG, volchanochnopodobny syndrome, the reaction at the injection.

     Networking : Metotreksat reduces antibodies to infliksimabu and increases the plasma concentration of the latter. Troop solution is not compatible (not to be confused) with other drugs.

     Overdosing : Clinical data on overdose lacking. A single dose of 20 mg / kg without toxic effects.

     Dosing and Administration : W / in, at speeds of no more than 2 ml / min for at least 2 h, using Tank system in apirogenny filter with a low belkovosvyazyvayuschey activity. In rheumatoid arthritis : a single dose of 3 mg / kg, followed by 2 and 6 weeks after the first introduction and further every 8 weeks (total number of introductions, 5-6). Treatment hold in the face of methotrexate. When illness Krona (active form) : 5 mg / kg once; When the fistula 5 mg / kg and then again after 2 weeks, and 6 weeks after the first injection. In the case of a relapse of disease recurrence treated for a period of 14 weeks after the last dose.

     Precautions : Before the therapy should cure manifestnye infections and abscesses. Doing expressed allergic reactions, severe infection or sepsis, development volchanochnopodobnogo syndrome treatment should stop. The emergence of severe allergic reactions requiring speed reduction or termination of infliksimaba Infusion. After removal or disappearance of a reaction resume more slowly. Use antihistamines drugs and paracetamol (for prevention), and adrenal corticosteroid (for edema) allergic reactions. Women of childbearing age at the time of treatment must use reliable contraception. Breastfeeding allowed no earlier than six months after the end of treatment.

Materials allowed to copy only with the active hyperlink to the handbook of medicines