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Musculoskeletal Services

Infliximab (Remicide) Anti-TNF

This information is offered as a guide to you and your family offering information on this treatment. Your treatment will be fully explained by your doctor or nurse, who will be happy to answer any questions.

What is an infliximab infusion?

Infliximab is a treatment which removes a protein called tumour necrosis factor (TNF) from the body. TNF causes inflammation and ultimately joint destruction.

Who benefits from the infusion?

People who suffer from rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and some connective tissue diseases who have not responded to other treatments can benefit from this treatment.

How is it given?

Infliximab is given directly into the bloodstream by a slow infusion through a cannula (fine tube). This is usually the hand or the arm. For the first five infusions infliximab is given over a two hour period with a further two hours for observation. If all is well the infusion time will be reduced to an hour with an hour observation.

The first few infusions are initially given at more frequent intervals. The second infusion given at week two with the third infusion at week six. For people with ankylosing spondylitis treatment will continue every six weeks, those with rheumatoid arthritis every eight weeks on the advice of your consultant.

Before the start of your infusion the doctor will take a blood sample to monitor your blood count. During the course of the infusion the nurse will monitor your blood pressure, temperature and pulse.

What are the side effects?

Reactions to the infusion can occur. Symptoms such as headache, fever, wheezing, a flushing feeling and nausea may be experienced during the infusion. Only a small number of patients experience these symptoms. Medication such as antihistamines and steroids can be given to counteract any side effects if necessary.

After the infusions there is some evidence that people are more prone to infections.

If any infections do occur they need to be treated urgently. You will be issued with an alert card for you to carry whilst having this treatment. This informs doctors, dentists and pharmacists of the treatment you are undergoing. It is essential that you carry this with you at all times.

Medication

Live vaccines such as rubella, yellow fever and bacillus calmette-guerin (BCG) should be avoided whilst having infliximab. Should a live vaccine be required infusions need to be suspended for a period of five months before the vaccine can be given. Flu vaccines should be given once yearly and pneumovax vaccines every five years. It is also very important for patients undergoing treatment that they should not become pregnant during that time or for a period of five months following the end of treatment. Any surgery should be planned for the mid point between infusions.

During the course of your treatment should you have any problems, questions or side effects please contact:
Monday to Friday 8.30am to 4.30pm
Karl Nicholl Specialist Nurse: 0191 223 1171
or
Michelle Rutherford Staff Nurse Ward 20 day unit 0191 233 6161 Ext 27752

Out of Hours
Monday to Friday On call Specialist Registrar 5.00pm to 7.00pm 0191 233 6161
Saturday / Sunday On call Specialist Registrar 9.00am-1.00pm 0191 233 6161
or contact your GP

Further information can be found at www.arthritisresearchuk.org


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