Infliximab

Characteristics

Himernye mashino-chelovecescie IgG1 monoclonal antibodies, consisting of variabelna (Fv) of vsokoaffinnah inactivates mouse monoclonal antibody to necrosis factor opouholi-alfa and fragment molecules IgGlk rights.

Of drugs

The drugs-immunomodulirutee. For high affinnostew to necrosis factor opouholi-alfa (Fno-alfa) is the sustainability of both the soluble, and the мембран-ассоциирован��ой forms of human Fno-alfa by reducing its functional activity. The decrease in Fno-alfa may modulate Apoptosis sinovialnah cells and inhibit sinovialnuu giperplaziu. Reduced concentration (bound ingibiruet fusion) interleikina-1 (IL1-1), interleikina-6 (YL-6), interleikina-8 (SILT-8), monocitarnogo hemoatraktantny protein-1, nitrogen oxide, metalloproteinaz (kollagenaza, stromelizin), and other inducers inflammation and tissue destruction and the level of soluble adhesion molecules, ICAM-1 and E-selektina reflecting activation vascular endotelia (E. L. Nasonov, 2000). Effectiveness infliximaba in seronegativeh spondiloartropatiah (ancylosing spondylitis, poliartikuliarny psoriaticeski arthritis), and a crown (E. L. Nasonov, 2001). eliminates from the body within six months.

Indications

Rheumatoid arthritis (active form), and the ineffectiveness of previous therapy, including methotrexate (combined therapy with metotrexatom); Krone disease (active form), including : with the formation of fistulas in distress during and inefficiency korticosteroidami therapy and / or immunodepressantami.

Restrictions on the use of

Children's age (safety and efficacy of the children and adolescents under the age of 18 are not defined).

Pregnancy and lactation

Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.

Contraindications

Гиперчувствительност ь (including from other protein Die), sepsis, clinically expressed infection or abscess, pregnancy, breast-feeding.

Side-Effects

From the nervous system and sensory organs : 1-10% headache, dizziness; 0.1-1%, depression, paranoia, anxiety, amnesia, fatigue, nervousness, drowsiness, conjunctivitis, keratokongunguit, andoftalmit, periorbitalny Otek.so the circulatory system and blood (blood, gemostaz) : 0,1-10% tides petehii, ekhimoz / bruise, giper-/gipotenzia, aetiology, palpitations, irregular, patients receptacles, the peripheral blood circulation, throm, collapses; 0.1-1% anaemia, leiko-, limfo-, stoichiometric, thrombocytopenia, limfozitos, Limfadenopatia.so the respiratory system : 0,1-10% sinusit, active bleeding, infections of the upper respiratory tract, bronchitis, pneumonia, pleurisy, dizziness, swelling Legkih.so part of the intestine : 0,1-10% heilit, nausea, diarrhoea or constipation, neuralgia, jeludern-pishchevodny reflux, divertikulit, holetsistit violation of Pecheni.so the urogenital system : 0.1-1% infection urinary tract (medicine, etc.), vaginitis, Oteki.so the Skin : 0,1-10% sweating, dry skin, giperkeratos, pigmentation of skin, zianoz, gribkovi dermatitis (onihomikoz, eczema), seborrhea, birthmarks, warts, furunkoulez, alopecia, bulleznaya Sapi.allergicakie reactions : 0,1-10% skin rashes, itching, urticaria, bronhospazm etc. allergic Proementa.prochie : 0,1-10% of infections (influenza, herpes, fever, abscess, cellulite, sepsis, bacterial and fungal diseases), fatigue, and recovery syndrome (including pain in the chest, abdomen); 0.1-1% mialgia, artralgia, education IgG, volchanochnopodobnyy syndrome, the reactions at the injection.

Patient interaction

Methotrexate reduces antibodies to infliximabu and increases the concentration of plasma. Troop solution is not compatible (not to be confused) with other drugs.

Overdosing

Clinical data on overdose lacking. One in a dose of 20 mg / kg toxic effects did not.

Precautions

Prior to the start of therapy to cure manifestnye infections and abscesses. In developing expressed allergic reactions, severe infection or sepsis, the volchanochnopodobnogo syndrome treatment should be discontinued. The acute allergic reactions resulting in the need to reduce the speed infliximaba or termination infusions. After removal or disappearance of signs of a reaction started more slowly. Use antigistaminnah drugs and paracetamol (for prevention), and corticosteroid adrenaline (for short) allergic reactions. Women of child-bearing age at the time of treatment must use reliable methods of contraception. Breastfeeding allowed no earlier than six months after the end of treatment.

Dosing and Administration

In / in, and at speeds of up to 2 mL / min for a period of not less than two hours using infuzionna system, which apirogenny filter with a low belkovosvazavatei activity. In revmatoidnom arthritis : in one dose of 3 mg / kg, followed by 2 and 6 weeks after the first application and a further 8 weeks (total issuance, 5-6). Treatment out against the backdrop of methotrexate. In ulcerative disease (active form) : 5 mg / kg once; In the formation of fistulas, 5 mg / kg, and then repeated at two weeks and six weeks after the first injection. In the case of recidivism resumption of treatment may within 14 weeks after the last dose.

Literature

1. Nasonov Patients Necrosis factor opouholi-alfa-new target for противовоспалительно й Therapy rheumatoid arthritis / / RMJ .- 2000 .- T. 8-N-17 S. 718-722.2. Nasonov Patients Prospects drug inflammatory rheumatic diseases : monoclonal antibodies to necrosis factor opouholi-alfa / / RMJ .- 2001 .- T. 9-N 7-8.

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