Name of the Procedure:

Infliximab Infusion

• Common Name: Remicade Infusion
• Medical Term: Infliximab Therapy

Summary

Infliximab infusion is a medical procedure where a biologic medication called infliximab is administered intravenously to help reduce inflammation in certain chronic inflammatory conditions. The medication works by targeting and blocking a specific protein in the immune system known as tumor necrosis factor (TNF) that causes inflammation.

Purpose

Infliximab is used to manage and treat conditions such as Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. The goal of this therapy is to reduce inflammation, alleviate symptoms, and improve quality of life by preventing flare-ups and achieving remission.

Indications

• Symptoms of Crohn's disease and ulcerative colitis, such as severe abdominal pain, diarrhea, and weight loss.
• Joint pain, swelling, and stiffness associated with rheumatoid arthritis and psoriatic arthritis.
• Chronic inflammation in the spine and pelvis due to ankylosing spondylitis.
• Persistent skin plaques and lesions in plaque psoriasis.
• Ineffectiveness of conventional treatments or intolerance to other medications.

Preparation

• Patients may need to undergo blood tests to check for infections or other underlying conditions.
• A tuberculosis (TB) test is required to ensure the patient does not have latent TB.
• Pre-procedure medication adjustments might be needed, as directed by the healthcare provider.
• Fasting is generally not required, but patients should follow specific instructions from their healthcare team.

Procedure Description

1. Pre-Procedure Assessment: Vital signs are checked, and a brief health assessment is conducted.
2. IV Line Placement: An intravenous (IV) line is inserted into the patient’s arm.
3. Medication Preparation: Infliximab is prepared in a sterile environment and mixed with saline.
4. Infusion: The infliximab solution is administered through the IV line over a period of 2 to 3 hours.
5. Monitoring: Patients are monitored for any adverse reactions during and after the infusion.

• Tools and Equipment: IV line, infusion pump, saline solution, infliximab medication.
• Anesthesia or Sedation: None required, though antihistamines or corticosteroids may be given to prevent allergic reactions.

Duration

The infusion typically takes between 2 to 3 hours.

Setting

Infusions are usually performed in an outpatient clinic, hospital infusion center, or specialized infusion facility.

Personnel

• Infusion Nurse
• Healthcare Provider (e.g., a rheumatologist or gastroenterologist)
• Pharmacist
• Medical Assistant

Risks and Complications

• Common risks: Headache, fever, chills, nausea, fatigue.
• Rare risks: Serious infections, allergic reactions, heart problems, liver damage, reactivation of TB.
• Complication management includes stopping the infusion and administering emergency medications if severe reactions occur.

Benefits

• Reduction in inflammation and relief from symptoms.
• Potential to achieve long-term remission of the condition.
• Improvement in overall quality of life.

Recovery

• Post-procedure observation for a short period to ensure no immediate adverse reactions.
• Normal activities can usually be resumed immediately, though some patients may experience mild fatigue.
• Follow-up appointments are necessary to assess response and adjust treatment.

Alternatives

• Oral medications such as corticosteroids, methotrexate, or other disease-modifying antirheumatic drugs (DMARDs).
• Biologic alternatives like adalimumab (Humira) or etanercept (Enbrel).
• Pros and cons: Alternatives may be less effective or slower to work, with different side effect profiles.

Patient Experience

• Some patients may feel anxious or uncomfortable during the IV insertion.
• Pain management includes applying a numbing cream prior to IV insertion if needed.
• Post-infusion fatigue is common; patients are advised to rest and stay hydrated.