Remicade™ and Rheumatoid Arthritis
TNF-α1 is a cytokine2 that is instrumental in the inflammatory process of RA3. Besides its
role in causing inflammation, TNF-α has also been shown to lead to the death of cells and
to the destructive erosions of articular cartilage4 that are seen in RA.
Cytokines, like many other types of biologically active substances, are able to work only
if they can bind to specifically matched receptors, like keys in locks. Receptors may be
found on the surfaces of cells or floating in the serum5 of the blood. Any substance that
specifically matches the shape of such a biologically active protein can bind to it,
rendering it unable to perform its normal job. This is akin to attaching a rubber
blade-guard to the blade of an ice skate. The blade-guard specifically matches the shape of
the ice skate’s blade, but once attached, it renders the ice skate blade incapable of
TNF-α inhibitors are genetically engineered proteins that bind specifically to the TNF-α of
RA patients, thereby inhibiting the biologic activity of the TNF-α, just like putting a
blade-guard on an ice skate. TNF-α inhibitors have been shown to substantially reduce the
joint destruction seen in RA and to substantially reduce the pain and inflammation of the
Because biologics like Remicade™ are not chemicals like most medications, they tend not to
cause side effects in the liver and kidney, common to many other drugs. Side effects of
Remicade™ include occasional reactions during the infusion which are quickly handled by
on-site medical staff, and occasional increased susceptibility to infection. Studies have
shown that the incidence of infections is relatively low and outweighed by the benefits of
significant suppression of the symptoms, signs, and joint destruction of RA.
TNF-α inhibitors are among the first fruits of the new revolution in genetic medicine. They
are made by E. coli bacteria whose chromosomes have had new genes (artificially made by man
and similar to viruses) inserted into them by recombinant DNA techniques. These incredible
agents, truly at the cutting edge of science, can be compared to the earliest products of
the antibiotic era, like penicillin in 1940. Hopefully, the next few years will see similar
products capable of arresting other disease processes as effectively as the TNF-α
inhibitors have affected RA6.
The Arthritis Center of Connecticut is proud to have been in the vanguard of this
biological assault on RA, having participated in studies of the effectiveness and safety of
Remicade™, a brand name TNF-α inhibitor, undertaken to obtain FDA (Food and Drug
The Arthritis Center serves its Remicade™ patients in its dedicated Infusion Center. Since
Remicade™ must be administered by intravenous (IV) infusion it is essential to create the
most comfortable environment possible. The Infusion Center is staffed by skilled
professionals highly experienced in intravenous therapy. Most uncomplicated infusions are
completed in less than half the time required by regular hospitals.
Our Infusion Center
The staff of the Infusion Center is trained and experienced in all aspects of IV
infusion, including routine and emergency procedures. A physician assistant and a doctor
are always on the premises in addition to at least one of our RN infusion specialists and
our regular medical assistants. Infusion Center patients are offered refreshments and the
services of a professional reflexologist at no charge.
Our billing department takes care of all insurance issues including pre-authorization, even
for patients referred by outside physicians. Currently, the Infusion Center serves patients
referred by many different doctors and from different states.
The Infusion Center is a pleasant and comfortable setting especially designed to ease the
fears of those anticipating a new form of treatment. Every effort is made to make the
infusion treatment as pleasant as possible. Besides the care of the patient’s primary
disease, the personal privacy and the physical and emotional comfort of our patients are
the paramount concerns of our staff. For these reasons we accept transfers from other
In addition to treating RA patients with Remicade™, the Infusion Center offers
treatment for patients with Crohn’s disease and treatment with other IV medications,
including, but not necessarily limited to, Aredia™ for osteoporosis, InFed™ for iron
deficiency anemia in those who can not tolerate oral iron, and antibiotics.
For more information, patients or their physicians can call the Arthritis Center at