Infliximab (Remicade (R)) for the treatment of ankylosing spondylitis

Canadian Coordinating Office for Health Technology Assessment
Record ID 32004000173
English, French
Authors' objectives:

To summarize the available information on the use of infliximab (trade name Remicade, marketed by Schering Canada Inc.) for the treatment of patients with ankylosing spondylitis who have severe axial skeleton symptoms and elevated serological markers of inflammatory activity, and who have responded inadequately to conventional therapy.

Authors' recommendations: A growing amount of literature explores new technologies aimed at altering tumour necrosis factor (TNF) alpha activity in patients with ankylosing spondylitis. The Canadian Rheumatology Association has published a consensus on the use of these agents in the treatment of spondyloarthropies, recommending their use in some patients who are refractory to traditional therapy (i.e., NSAIDs, sulfasalazine in peripheral arthritis). The international consensus document, published subsequent to the Canadian guidlines, also suggests that a specialist should implement the use of anti-TNF alpha agents in refractory disease. Several issues may be of concern: the price of the drug, its potential for long-term use, and the possibility of 'prescription creep' if higher than recommended dosage or increased dosage frequency are used. Unanswered questions remain regarding the optimal dose, long-term safety, and impact on disease progression. Although no trials have compared infliximab with other TNF alpha inhibitors such as etanercept, the choice of drug may be influenced by the route of administration (infliximab is administered intravenously, while etanercept is administered subcutaneously) and the perception of potential for harm.
Authors' methods: Overview
Project Status: Completed
URL for project:
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Antirheumatic Agents
  • Costs and Cost Analysis
  • Tumor Necrosis Factor-alpha
  • Spondylitis, Ankylosing
Organisation Name: Canadian Coordinating Office for Health Technology Assessment
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
Contact Name:
Contact Email:
Copyright: Canadian Coordinating Office for Health Technology Assessment (CCOHTA)
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