Infliximab (brand name Remicade, pronounced REM-ih-kaid) is a systemic biologic therapy currently approved for the treatment of Crohn's disease (an inflammatory bowel disease) and rheumatoid arthritis (in combination with methotrexate). Remicade was approved for Crohn's disease in 1998 and for rheumatoid arthritis in 1999. It is prescribed "off-label" for psoriatic arthritis, meaning physicians can prescribe it, but it hasn't been approved for psoriatic arthritis by the U.S. Food and Drug Administration. It is also being studied for treating psoriasis.

How does it work?

Remicade specifically targets a key cellular messenger involved in psoriasis and psoriatic arthritis. This messenger is called "TNF-alpha" and it causes inflammation and activation of the immune system. Overproduction of TNF-alpha is believed to play a role in psoriatic arthritis, rheumatoid arthritis and Crohn's disease. Remicade binds to TNF-alpha on the cell emmbrane and in the blood.

Remicade is given by IV infusion in a doctor's office over a two-to-four-hour period.

What are the side effects?

Remicade appears to contribute to the emergence of tuberculosis (TB) in patients who have a silent, or dormant TB infection. Rheumatologists should test any patient for dormant tuberculosis prior to prescribing anti-TNF therapy. There are also reports of serious infusion reactions with hives, difficulty breathing and low blood pressure.

In clinical studies, some people experienced the following common side effects:

• Upper respiratory infections
• Headache
• Nausea
• Cough
• Sinusitis
• Rash or itch skin at infusion site