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Infliximab-abda is a biosimilar monoclonal antibody that targets tumor necrosis factor-alpha (TNF-α), a cytokine involved in inflammatory and autoimmune pathophysiology. This activity presents a focused review of infliximab-abda's mechanism of action, therapeutic indications across dermatology, immunology, gastroenterology, and rheumatology, and relevant contraindications. Particular attention is given to the historical context of anti-TNF-α therapy, beginning with FDA approval in 1998 and subsequent dermatologic use in 2002. The activity addresses adverse effects, dosing protocols, and clinically significant drug interactions to support the appropriate administration of infliximab-abda. Strategies to mitigate toxicity while optimizing therapeutic benefit are emphasized. Emphasis is placed on the role of the interprofessional healthcare team in patient selection, monitoring, and long-term management. By presenting current evidence and practical application, this activity supports safe and effective use of infliximab-abda in clinical practice. Objectives: Identify the mechanism of action of infliximab-abda. Assess the adverse effects of infliximab-abda. Screen patients for contraindications against infliximab-abda administration. Implement effective collaboration and communication among interprofessional team members to improve outcomes and treatment efficacy for patients who might benefit from infliximab-abda therapy. Access free multiple choice questions on this topic.

Signs and Symptoms of Overdose Overuse of infliximab leads to prolonged TNF-α inhibition, thereby increasing the risk of infections. This furthermore poses deleterious effects on pregnancy and lactation by impairing the newborn’s defense mechanisms. Since TNF-α is involved in embryogenesis and organogenesis, a deleterious effect on embryo and fetal development is postulated. Another toxic effect of infliximab is the carcinogenic potential resulting from reports of malignancies in children, adolescents, and young adults receiving infliximab over a median of 30 sessions. This hypothesis comes from the finding that TNF-α causes tumoral hemorrhagic necrosis and is therefore used as a treatment for selective tumors.[67] Management of Overdose There is no antidote for infliximab. In case of overdose, it is recommended that the patient be monitored for any signs or symptoms of adverse reactions or effects/precautions listed above. Symptomatic treatment should be initiated immediately.

The primary drawback with biologic therapy is the necessity for lifelong or long-term treatment, the failure of which can lead to incomplete resolution or recurrences. Combination with other agents, such as methotrexate, can enhance the efficacy and response.[68] Live vaccines and contact with infectious agents should be avoided during infliximab therapy due to the markedly depressed immunity that can result in disseminated infections.[69] A history of latent or active tuberculosis with no confirmation of complete therapy or recent travel to a country with a high incidence of tuberculosis may warrant a course of empiric anti-tubercular treatment. Avoidance of concomitant therapy with anakinra and abatacept is essential due to the increased risk of severe infections.[70] Primary care physicians and advanced practice providers evaluate patients for infliximab and initiate baseline screening. Nurses educate, prepare, administer infusions, monitor vital signs and reactions, and escalate concerns as needed. Pharmacists verify dosing, ensure proper preparation, and check for drug interactions. Internists play a crucial role in the comprehensive care of hospitalized patients with multiple comorbidities. Gastroenterologists manage infliximab therapy for inflammatory bowel disease, adjusting doses as needed. Rheumatologists and dermatologists collaborate on therapy for arthritis and psoriasis, assess disease progression, and guide biologic treatment. Consultation with an infectious disease specialist is required for fungal infections, tuberculosis, or HBV reactivation. Oncologists evaluate cancer risk and recurrence, guiding therapeutic decisions. Critical care specialists manage rare overdoses or severe reactions, providing intensive care as needed. As described above, an interprofessional team approach and communication among physicians, advanced practice providers, pharmacists, and nurses are crucial to decreasing potential adverse effects and improving patient outcomes related to infliximab therapy.