In the treatment of rheumatoid arthritis Remicade (infliximab) is given along with Methotrexate. In other conditions such as psoriatic arthritis and ankylosing spondylitis, methotrexate may not be used as much. There are several considerations in using methotrexate with infliximab. Methotrexate may decrease the chance of developing blocking antibodies against the infused drug, thus prolonging the period of time that someone can take the medication. In RA from many clinical trials we have learned that from an efficacy perspective, MTX combined with a TNF inhibitor leads to more improvement than the biologic alone. Other drugs however have been used with infliximab in place of methotrexate including leflunomide, sulfasalazine, and azathioprine.
About Clifton Bingham, III, MD
Associate Professor of Medicine
Director - Johns Hopkins Arthritis Center