What is Infliximab?
Infliximab is a monoclonal antibody. It is a very potent drug that suppresses the immune system and has anti-inflammatory effects. It is used in various rheumatic diseases, chronic inflammatory bowel diseases and the skin disease psoriasis.
It can be administered only as an intravenous infusion, which is why Infliximab must be administered in day clinics or as an inpatient. Infliximab has been approved in the European Union under the trade name Remicade® since 1999. Infliximab is covered by health insurance companies if the indication for therapy with Infliximab is given.
What are biologics?
Biologics are drugs that are very similar to the body’s own natural structures. This enables them to intervene very effectively and specifically in the processes of the immune system and thus combat diseases. For this reason they are also called “biological drugs”, the term “biologicals” is derived from the English word “biologicals”.
In most cases, biologicals are intended to imitate certain protein structures. These are called antibodies. Infliximab, for example, is a monoclonal antibody against tumor necrosis factor-alpha, an important mediator in the immune system.
Under which trade names is Infliximab on the market in Germany?
The first Infliximab preparation was launched in Germany under the trade name Remicade®. For many years, this preparation from MSD was the only one available. Only in 2013 a biosimilar was approved in Germany.
Biosimilars are imitation products that can only be produced and sold when the patent of the original product has expired. Infliximab 2013, for example, entered pharmacies under two other trade names: as Inflectra® from Hospira and Remsima® from the pharmaceutical company Celltrion. They have the same effect as the original Remicade®.
Another biosimilar was then released for the German market in 2016. The company Samsung Bioepis sells it under the trade name Flixabi®. It is likely that other pharmaceutical companies will develop biosimilars of Infliximab.
Indications for Infliximab
Indications are reasons for the use of a drug. Infliximab is an immunosuppressant, i.e. it suppresses the immune system. It can therefore be used for various inflammatory diseases.
In Germany, rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are indications. It is also used in chronic inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. Finally, psoriasis is also an indication for therapy with Infliximab.
The first indication for Infliximab was Crohn’s disease and the drug is still approved today as a therapy for this chronic inflammatory bowel disease. However, the therapy concept for Crohn’s disease is structured like a ladder. The first step is therefore to start with basic therapeutics that are better tolerated and have fewer side effects.
These include for example locally acting glucocorticoids. If these are no longer effective or if an acute relapse occurs, the next stage of therapy is initiated. Immunosuppressive drugs such as Infliximab are only in last place on this ladder.
It is also used especially in young patients, who can usually tolerate such a strong inhibition of the immune system a little better than older people. Infliximab is also used in ulcerative colitis. Indications for its use are moderately severe to severe attacks in adults; it is only rarely used in children. It can also be administered when no other drug is responding, therapy with glucocorticoids or other immunosuppressive drugs has been unsuccessful or there are contraindications for other therapeutic measures. These include allergies or side effects that could have an adverse effect on the patient’s residual health.
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