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TNF-α Inhibitor (Chimeric Monoclonal Antibody)

Infliximab (Rheumatology)

Brand names: Remicade, Inflectra, Remsima, Zessly

This is infliximab used in rheumatology as a specialist-initiated biological disease-modifying antirheumatic drug for rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, given by intravenous infusion (with subcutaneous formulations also available).

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Infliximab is a chimeric monoclonal antibody that binds and neutralises tumour necrosis factor alpha (TNF-α), a key cytokine driving inflammatory joint disease.

Prescribing in practice

  • Serious infection risk, including reactivation of latent tuberculosis and hepatitis B, is the principal hazard, so screening before initiation is mandatory.
  • Infusion reactions and delayed hypersensitivity can occur, so infusions are given under supervision with appropriate precautions.
  • Live vaccines are contraindicated during treatment and it is generally avoided in moderate-to-severe heart failure and active malignancy.

Monitoring

Monitor for infection, infusion reactions and, periodically, full blood count and liver function, following pre-treatment tuberculosis and hepatitis screening as per the SPC.

Counselling the patient

  • Report fever, persistent cough, weight loss or any signs of infection promptly.
  • Carry a biologic alert card and tell clinicians you receive this treatment.
  • Ensure vaccinations are up to date and avoid live vaccines without advice.

Evidence & guidelines

Extensive randomised controlled trial evidence establishes infliximab's efficacy in reducing disease activity and radiographic progression across inflammatory arthritides.

Reference: NICE TA130; ATTRACT trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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