Infliximab (Remsima)
Remsima (infliximab) is a biologic medicine that helps the pain and swelling of arthritis.
Remsima is used in the treatment of Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Crohn’s Disease, Ulcerative Colitis, Psoriasis, and other types of arthritis.
It works by blocking Tumor Necrosis Factor (TNF), a type of signalling protein (called a cytokine), that is involved in systemic inflammation. Remsima belongs to a class of similar medications called Anti-Tumor Necrosis Factor agents.
Biosimilar
Remsima is a type of medicine that is called a biosimilar. A biosimilar is a type of biologic medication that has been designed to be identical to an existing biologic medication, but created using a different process.
Remsima is a biosimilar of Remicade. Both medications are known by the same generic name: infliximab. Biosimilars are often cheaper than the original medication.
Taking Remsima
Remsima is available as an injection (Remsima SC) and as an intravenous infusion (Remsima IV). The injection can be done quickly at home. The infusion is done every 6 to 8 weeks at a specialized infusion clinic.
The normal dose for the injection is 120 mg, once every 2 weeks.
Some Remsima SC patients may start by receiving two Remsima IV loading doses on week 0 and week 2. Four weeks after the last IV loading dose the first injection of Remsima SC 120 mg is taken. Remsima is then continued as 120 mg injections every 2 weeks.
Watch our video to learn how inject Remsima at home:
Learn how to inject subcutaneous injectionsSubcutaneous injections (under the skin injections) are easy to do compared to other types of injections. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
A typical starting dose for Remsima IV is 3-5 mg per kilogram of body weight. The dose may be increased over time.
Patients start by receiving infusions on week 0, week 2, and week 6. After that, they receive infusions every 6 to 8 weeks depending on their doctor’s prescription.
Infusions usually take about 2 hours.
Some patients start to feel better quickly with Remsima, but in others, it can take a little longer. It’s important for people starting this medication to be patient, give it some time, and continue receiving infusions as prescribed by their doctor.
The manufacturer of Remsima offers a support program to Canadian patients that are prescribed the medication:
Patient support program enrolment formsImportant Tests and Risks
Remsima can make it a bit harder for people to fight off infections. Patients taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Patients should coordinate with their doctor to stop treatment before any surgery, and re-start once things have healed and there’s no sign of infection.
Patients should discuss all vaccinations with their doctor because some (live vaccines) are not advisable to get while taking Remsima.
It is important to have a tuberculosis skin test done and get a chest x-ray before starting Remsima.
Patients who are taking Remsima should have occasional blood tests as requested by their doctor to keep track of their arthritis and make sure that blood counts are ok.
Science
In some people with arthritis, a type of signalling protein (cytokine) called Tumor Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain and swelling).
Remsima (infliximab) is another type of protein called a monoclonal antibody that works as a Tumor Necrosis Factor blocker: it blocks the action of Tumor Necrosis Factor.
In blocking Tumor Necrosis Factor, Remsima suppresses the body’s immune system. Though this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system.
In patients with arthritis, this medicine can:
- Reduce the pain and swelling (inflammation) in arthritic joints
- Improve day to day function
- Prevent long-term damage caused by joint inflammation
Safety
Patients taking Remsima (infliximab) should talk to their doctor if they are concerned about any side effects.
MORE COMMON side-effects include:
- Mild skin reaction at the injection site (itchiness, redness, and mild swelling).
- Abdominal pain, nausea, vomiting, and diarrhea.
- Back pain, aching joints.
- Rash, flushing.
- Headaches.
- Upper respiratory tract infections (such as sinusitis).
RARE side-effects include:
- Infusion Reaction – Some patients may react to the IV medication during or shortly after it is administered.
- Infection – There is an increased risk of serious infections associated with the use of this medication. Any infections or fevers should be taken very seriously and be reviewed by a doctor.
- Nervous System – There have been very rare reports of some patients developing disorders that affect the nervous system (multiple sclerosis, seizures, or inflammation of the nerves of the eye) while taking Remsima. Fortunately, these reports are exceedingly rare.
- Heart – Patients should inform their doctor if they have congestive heart failure as Remsima may make it worse.
- Malignancy – When used for long periods of time, Remsima may be associated with a small increased risk of cancer, however, the data is not entirely clear.
Patients who should NOT be taking Remsima or other brands of infliximab include:
- Patients who have had a previous serious allergic reaction to Remsima
- Possibly patients who have cancer or have had a past history of certain cancers
- Patients who have congestive heart failure
- Patients who have Lupus or multiple sclerosis
- Patients with active infections (such as tuberculosis)
Patients taking Remsima should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons to call a doctor while taking Remsima include:
- Fever or possible infection
- Another doctor has prescribed antibiotics to fight an infection
- Planning for surgery
- Becoming pregnant, or planning on pregnancy
- Planning on any vaccinations
- Developing a rash
Anyone who becomes pregnant while taking this medication should tell their doctor.
Pregnancy and medicationsVideo
Watch Canadian rheumatologist Dr. Andy Thompson introduce Remsima in this short video:
Resources
DIN
- 02419483 (IV)
- 02511576 (Pre-filled Syringe)
- 02511584 (Pre-filled Pen)