Off-label Uses and Side Effects of Infliximab
May 2004 | Volume 3 | Issue 3 | Original Article | 273 | Copyright © May 2004
Noah Scheinfeld, MD
Infliximab was first approved by the FDA in 1998 as a treatment of moderately-to-severely active Crohn’s disease in patients who have
an inadequate response to conventional therapies, and fistulizing Crohn’s disease. In November 1999 the FDA approved it for use in
rheumatoid arthritis with methotrexate, and further expanded this indication in December 2000. It appears to be a promising agent
in the treatment of a variety of inflammatory diseases, psoriasis in particular.
A MEDLINE search was performed for “infliximab” in February of 2004, and the 1,116 articles found were reviewed. Approximately
200 articles were identified that contained references to the treatment with infliximab of skin disease, off-label uses, systemic diseases
with cutaneous manifestations, and systemic and cutaneous side effects. These articles were reviewed and their contents summarized.
Infliximab has been proven in well-controlled trial trials to ameliorate inflammatory bowel disease, rheumatoid arthritis, psoriasis, psoriatic
arthritis, and ankylosing spondylitis. Anecdotal reports report it useful in treating the cutaneous manifestations and associations
of inflammatory bowel disease, Behçet’s disease, graft versus host disease, Sjogren’s syndrome, refractory sarcoidosis, and a variety
of other conditions. Its notable side effects include an increased risk of the induction of infections (e.g., tuberculosis).
Infliximab is a very promising medication in the treatment of inflammatory dermatological conditions and should be used in larger
scale trials of more diseases.