Infliximab respiratory system

Infliximab (Remicade) is a chimeric monoclonal antibody directed against TNF-a. Recently, its indications have been expanded to include psoriatic arthritis and treatment of adults with chronic severe plaque psoriasis. An advantage over other systemic psoriasis treatments is that infliximab does not adversely affect blood counts, hepatic enzyme levels, or kidney function. The recommended dose is 5 mg/kg as an IV infusion at weeks 0, 2, and 6, then every 8 weeks thereafter. For psoriatic arthritis, it may be used with or without methotrexate. Adverse effects include headaches, fever, chills, fatigue, diarrhea, pharyngitis, upper respiratory and urinary tract infec-... 

The most common adverse effects of infliximab are headaches, fever, chills, fatigue, diarrhea, pharyngitis, upper respiratory and urinary tract infections, and hypersensitivity reactions (urticaria, dyspnea, and hypotension). Infliximab has been also associated with infections and lymphoproliferative disorders. It is not associated with end-organ toxicity, and blood counts, liver enzyme levels, kidney function, and complement values can be expected to remain normal during treatment. This gives it a major advantage over other systemic psoriasis treatments. 

Systemic and cutaneous reactions have been reported following administration of infliximab. These include anaphylaxis, serum sickness, maculopapular rashes, urticaria, psoriasis, flare-up of atopic dermatitis, and leukocytoclastic vascuhtis. The overall incidence of infusion reactions in one study was 6.1 %. Mild, moderate, and severe reactions occurred in 3.1, 1.2, and 1 % of infliximab infusions, respectively. Patients with lymphocyte counts greater than 50 XIQP/L experienced a severe cytokine release syndrome shown by peaks in release of TNF and lL-6 90 min after infusion with rituximab. A number of post-infusion hypersensitivity or hypersensitivity-like reactions occur to rituximab. These reactions include serum sickness, vasculitis, various cutaneous manifestations, interstitial pneumonitis, and acute respiratory distress syndrome. 

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