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Rheumatoid Arthritis

Understanding RA

How RA Progresses

Importance of
Earlier Treatment of RA

REMICADE for RA

Talking to Your Rheumatologist

Your RA Community

Please read the Medication Guide for REMICADE® and discuss with your doctor.

How RA Progresses?

Self Assessment

Medical Specialist Locator

Beneath the Skin Interactive Video

Patient Stories

REMICADE News
and Updates

As rheumatoid arthritis (RA) progresses, it can lead to joint damage. A major cause of joint damage is the underlying inflammation triggered by a protein called tumor necrosis factor alpha (TNF-alpha). In rheumatoid arthritis, TNF can cause your immune system to attack healthy tissues in your body and cause inflammation and damage. If rheumatoid arthritis is left untreated, it can cause permanent damage to the body's bones, cartilage, and tissue.

In RA, the presence of TNF-alpha may lead to the following forms of joint damage:

Joint space narrowing (when the gap between bones closes)
Joint erosion (when inflammation causes bones to wear away at the joint)

Healthy Joint. Joint Damage from RA.

Joint erosion and joint space narrowing can both begin early in the disease and continue as it progresses, each independent of the other.

How rheumatoid arthritis progresses

Simply managing the symptoms of RA may not stop progression of the disease. So, even if pain and swelling are relieved, joint damage may still be continuing.

Joint damage can progress over time even when using disease-modifying antirheumatic drug (DMARD) therapy, including methotrexate.
Patients with active RA disease have a greater than 70% chance of developing joint damage within two years of the condition’s onset.
Advanced treatments such as REMICADE work to block one of the primary causes of the underlying inflammation. This helps stop disease progression by helping to stop further joint damage.

Controlling this progression is an important goal of successful rheumatoid arthritis therapy and makes early detection and diagnosis of RA absolutely critical to the management of the disease.

Joint Damage from RA
Take a journey beneath the skin for an in-depth view of a hand affected by joint damage from rheumatoid arthritis over time.

IMPORTANT SAFETY INFORMATION

Only your doctor can recommend a course of treatment after checking your health condition. REMICADE^® (infliximab) can cause serious side effects such as lowering your ability to fight infections. There are reports of serious infections caused by viruses, fungi or bacteria that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE^®.
Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. A rare form of fatal lymphoma has occurred mostly in teenage or young adult males with Crohn's disease or ulcerative colitis who were taking REMICADE^® and azathioprine or 6-mercaptopurine. For children and adults taking TNF blockers, including REMICADE^®, the chances of getting lymphoma or other cancers may increase. You should discuss any concerns about your health and medical care with your doctor.

What should I tell my doctor before I take REMICADE^®?

You should let your doctor know if you have or ever had any of the following:

Tuberculosis (TB) or have been near someone who has TB. Your doctor will check you for TB with a skin test. If you have latent (inactive) TB, you will begin TB treatment before you start REMICADE^®.
Lived in a region where certain fungal infections such as histoplasmosis or coccidioidomycosis are common.
Infections that keep coming back, have diabetes or an immune system problem.
Any type of cancer or a risk factor for developing cancer, for example, chronic obstructive pulmonary disease (COPD) or had phototherapy for psoriasis.
Heart failure or any heart condition. Many people with heart failure should not take REMICADE^®.
Hepatitis B virus (HBV) infection or think you may be a carrier of HBV.
Nervous system disorders (such as multiple sclerosis or Guillain-Barré syndrome).

Also tell your doctor about any medications you are taking, including vaccines or Kineret (anakinra), and if you are pregnant, plan to become pregnant or are nursing. Adults and children should not receive a live vaccine while REMICADE^®.

What should I watch for and talk to my doctor about before or while taking REMICADE^®?

The following serious (sometimes fatal) side effects have been reported in people taking REMICADE^®.

You should tell your doctor right away if you have any of the signs listed below:

Infections (such as TB, blood infections, pneumonia)—fever, tiredness, cough, flu, or warm, red or painful skin or any open sores. REMICADE^® can make you more likely to get an infection or make any infection that you have worse.
Lymphoma, or any other cancers in adults and children.
Heart failure—new or worsening symptoms, such as shortness of breath, swelling of your ankles or feet, or sudden weight gain.
Reactivation of HBV—feeling unwell, poor appetite, tiredness, fever, skin rash and/or joint pain.
Liver injury—jaundice (yellow skin and eyes), dark brown urine, right-sided abdominal pain, fever, or severe tiredness.
Blood disorders—fever that doesn't go away, bruising, bleeding or severe paleness.
Nervous system disorders—numbness, weakness, tingling, changes in your vision or seizures.
Allergic reactions during or after the infusion—hives, difficulty breathing, chest pain, high or low blood pressure, swelling of face and hands, and fever or chills.
Lupus-like syndrome—chest discomfort or pain that does not go away, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun. The more common side effects with REMICADE^® are respiratory infections (that may include sinus infections and sore throat), headache, rash, coughing and stomach pain.
Psoriasis—new or worsening psoriasis such as red scaly patches or raised bumps on the skin that are filled with pus.

Medication Guide for REMICADE^®

Please read the Medication Guide for REMICADE^® and discuss it with your doctor.
(Requires Adobe^® Reader^®. Click here to download.)

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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Last Updated: November 18, 2009