Greater Glasgow and Clyde Medicines

Restrictions:

Restricted to specialist use only.

In adults, infliximab is restricted to initiation by consultant rheumatologists for the following:

Rheumatoid arthritis

• In combination with methotrexate, may be used for the treatment of severe arthritis in accordance with local guidelines.
• In combination with methotrexate, may be used for the treatment of moderate arthritis in accordance with local guidelines only if:

  • intensive therapy with 2 or more conventional disease-modifying antirheumatic drugs (DMARDs) has not controlled the disease well enough and

  • a disease activity score [DAS28] of 3.2 to 5.1
  • See NICE TA715 for further guidance relating to use in moderate disease.
• Can be used as monotherapy when methotrexate is contraindicated or not tolerated for moderate to severe arthritis as indicated above

Psoriatic arthritis

• Restricted to criteria set out in NICE Technology Appraisal 104.

Ankylosing spondylitis

• Restricted to use in accordance with recommendations made in the NICE TA 383 click here.

Prescribing Notes:

Infliximab should be prescribed by brand name. Remsima^® is the preferred biosimilar.

BNF Link

Restrictions:

Restricted to specialist use only. Treatment of severe plaque psoriasis in adults is restricted to specialist use in patients who failed to respond to, or who have a contraindication to, or are intolerant of other systemic therapy including ciclosporin, methotrexate or psoralen ultraviolet A (PUVA) and in accordance with the local approved protocol.

Prescribing Notes:

Infliximab should be prescribed by brand name. Remsima^® is the preferred biosimilar.

BNF Link

Restrictions:

Restricted to specialist use as outlined in the prescribing notes below

Prescribing Notes:

Infliximab should be prescribed by brand name. Remsima^® is the preferred biosimilar.

Crohn's disease:

• Use in severe active Crohn's disease is restricted to patients whose disease has not responded to, or who are intolerant of or have contraindications to conventional therapy (including immunosuppressive and/or corticosteroid treatment).
• Use in active fistulating Crohn's disease is restricted to patients whose disease has not responded to, or who are intolerant of or have contraindications to conventional therapy (including antibiotics, drainage and immunosuppressive treatments).
• Use in the treatment of severe, active Crohn’s disease in paediatric patients aged 6 to 17 years of age is restricted to specialist use in patients who have not responded to conventional therapy.

Ulcerative colitis:

Use in the treatment of moderately to severely active ulcerative colitis in adults is restricted to those patients whose disease has responded inadequately to conventional therapy, including corticosteroids, mercaptopurine and azathioprine, or who cannot tolerate, or have medical contraindications for such therapies.

Link to relevant NHSGGC guidelines 

BNF Link