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MGNS. Heidi Johnson-Gazzard IBD CNS, City Hospital, Birmingham. INFLIXIMAB. INFLIXIMAB WAS LICENSED AS A TREATMENT FOR SEVERE CROHNS DISEASE IN ADULTS IN AUGUST 1999 SINCE THEN, THE NUMBERS OF PTS RECEIVING INFLIXIMAB HAS GROWN SIGNIFICANTLY ITS USE IS NOW COMMONPLACE IN MANAGING SEVERE IBD.
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MGNS Heidi Johnson-Gazzard IBD CNS, City Hospital, Birmingham.
INFLIXIMAB • INFLIXIMAB WAS LICENSED AS A TREATMENT FOR SEVERE CROHNS DISEASE IN ADULTS IN AUGUST 1999 • SINCE THEN, THE NUMBERS OF PTS RECEIVING INFLIXIMAB HAS GROWN SIGNIFICANTLY • ITS USE IS NOW COMMONPLACE IN MANAGING SEVERE IBD
INFLIXIMAB • NURSES ARE FREQUENTLY ACCEPTING RESPONSIBILITY FOR PREPARING PTS FOR THERAPY, ENSURING SAFE INFUSIONS & PROVIDING CO-ORDINATED FOLLOW-UP
INFLIXIMAB • COMPLEX AND SEVERE IBD, PLUS THE POTENTIAL SIDE EFFECTS OF INFLIXIMAB OFTEN LEAVE NURSES FEELING APPREHENSIVE REGARDING ITS USE
INFLIXIMAB • INFLIXIMAB IS A MONOCLONAL ANTIBODY (PRODUCED BY A SINGLE CLONE OF CELLS) THAT BINDS WITH HIGH AFFINITY TO TUMOUR NECROSIS FACTOR (TNF) ALPHA, A KEY MEDIATOR OF INFLAMMATION
INFLIXIMAB • BOUND TO INFLIXIMAB, TNF ALPHA IS UNABLE TO OR HAS REDUCED ABILITY TO PARTICIPATE IN THE INFLAMMATORY CASCADE THAT LEADS TO THE MUCOSAL INFLAMMATION AND ULCERATION OF IBD
INFLIXIMAB • REFERRED TO AS TNF INHIBITOR OR “ANTI-TNF” • INFLIXIMAB HAS PROVEN TO BE AN EFFECTIVE TREATMENT IN CROHNS DISEASE AND ULCERATIVE COLITIS, ASWELL AS SEVERAL OTHER AUTO IMMUNE DISEASES (RHEUMATOID ARTHRITIS, ANKYLOSING SPONDYLITIS, PSORIASIS & PSORIATIC ARTHRITIS)
INFLIXIMAB • THE DECISION TO INITIATE INFLIXIMAB TREATMENT SHOULD BE MADE BY THE CONSULTANT, PREFERABLY IN CONJUNCTION WITH A MULTIDISCIPLINARY TEAM EXPERIENCED IN THE MANAGEMENT OF IBD
INFLIXIMAB • IN CROHNS DISEASE, INFLIXIMAB IS INDICATED FOR: SEVERE ACTIVE DISEASE IN ADULTS WHO HAVE NOT RESPONDED DESPITE STEROIDS AND/OR IMMUNOSUPPRESSANTS AND IN THE TREATMENT OF FISTULATING ACTIVE DISEASE WHICH HAS NOT RESPONDED TO CONVENTIONAL TX
INFLIXIMAB • IN CROHNS DISEASE, INFLIXIMAB IS INDICATED FOR: SEVERE ACTIVE DISEASE IN ADULTS WHO HAVE NOT RESPONDED DESPITE STEROIDS AND/OR IMMUNOSUPPRESSANTS AND IN THE TREATMENT OF FISTULATING ACTIVE DISEASE WHICH HAS NOT RESPONDED TO CONVENTIONAL TX
INFLIXIMAB • IN ULCERATIVE COLITIS, INFLIXIMAB IS INDICATED FOR TREATMENT OF MODERATELY–SEVERELY ACTIVE INFLAMMATION IN PTS WHO HAVE HAD AN INADEQUATE RESPONSE TO CONVENTIONAL THERAPY
INFLIXIMAB • THERE MUST BE A DEFINED CLINICAL RESPONSIBILITY AND PROTOCOLS FOR THE PRESCRIBING, ADMINISTRATION AND MONITORING OF BIOLOGICAL THERAPIES, IN AN APPROPRIATE CLINICAL SETTING • OUTCOMES OF BIOLOGICAL THERAPY SHOULD BE REVIEWED REGULARY
INFLIXIMAB • INFLIXIMAB IS ADMINISTERD INTRAVENOUSLY AS A 2 HR INFUSION AT 5MG/KG BODY WEIGHT • IT IS IMPORTANT TO WEIGH THE PT BEFORE EACH INFUSION TO ENSURE THE CORRECT DOSE IS GIVEN
INFLIXIMAB • COST - £??? per 100mg vial • ADMINISTRATION OF INFUSION
INFLIXIMAB • INDUCTION GIVEN AT WEEKS 0,2 & 6. • ONCE PT RESPONSE HAS BEEN ESTABLISHED, MAINTAINENCE THERAPY IS RECOMMENDED • MAINTAINENCE GIVEN EVERY 8 WEEKS