Combination therapy of the chimeric monoclonal anti-tumor necrosis factor alpha antibody (infliximab) with methotrexate in patients with rheumatoid arthritis

Infliximab, a chimeric anti-TNF alpha antibody, showed in two double-blind placebo-controlled trials efficacy in combination with methotrexate (MTX) i npatients with severe rheumatoid arthritis (RA). Whereas in the first trial low-dose MIX or placebo was compared to infliximab alone and in combinatio n, the second trial compared infliximab to placebo inpatients with active R A despite maximal tolerated MTX treatment. Infliximab showed synergistic ef fects in combination with MTX. The immunogenicity of infliximab was reduced by the combination. Infliximab in combination with high-dose MTX is effect ive and safe in long-term treatment up to 54 weeks.