infliximab

Overview

Infliximab is a therapeutic monoclonal antibody used in the treatment of immune-mediated inflammatory diseases. It is best known as an anti-TNFα biologic, meaning it binds tumor necrosis factor alpha and helps suppress downstream inflammatory signaling. Clinically, this mechanism has made infliximab an important therapy in conditions such as inflammatory bowel disease and other chronic inflammatory disorders in which TNF-driven immune activation contributes to tissue damage.

Because infliximab modulates a central inflammatory pathway, it is also a useful reference drug in translational research on biologic efficacy, safety, biosimilar switching, and mechanisms of treatment resistance. Recent studies have continued to use infliximab as a comparator, a treatment intervention, or a mechanistic benchmark alongside other biologics such as adalimumab, etanercept, ixekizumab, risankizumab, and ustekinumab.

Focus of Latest Publications

Recent publications on infliximab have focused on its use in inflammatory bowel disease, central nervous system tuberculosis, and mechanistic or formulation-related contexts. In pediatric inflammatory bowel disease, a narrative review highlighted infliximab as one of only three advanced therapies currently approved for children, while emphasizing that much of the evidence base still relies on extrapolation from adult studies and that real-world evidence is needed to better define benefit-risk balance, including serious infection risk. A retrospective cohort study also set out to compare the risk of heart failure in patients with inflammatory bowel disease treated with infliximab versus adalimumab, reflecting ongoing interest in comparative cardiac safety among anti-TNF agents.

Several studies examined infliximab in relation to treatment switching, biosimilar use, and disease control. A population-based study from British Columbia evaluated the longer-term impact of mandatory non-medical switching policies on infliximab and adalimumab biosimilar utilization and on continuation or discontinuation patterns in Crohn’s disease and ulcerative colitis. In a separate case report, infliximab was associated with healing of a refractory ileocecal ulcer in Crohn’s disease after failure of adalimumab and risankizumab, with improvement linked to changes in mucosal claudin mRNA expression, suggesting a possible role in restoring barrier integrity.

Infliximab has also been studied outside gastrointestinal disease. A retrospective cohort study in severe central nervous system tuberculosis evaluated low-dose infliximab at 5 mg/kg as adjunctive therapy in 20 patients; at 3 months, 60% achieved disability-free survival and 75% showed clinically meaningful improvement, with outcomes reported as comparable to prior high-dose infliximab reports. The authors noted that randomized trials are needed to optimize dosing.

In a formulation-focused biophysical study, infliximab was included among therapeutic monoclonal antibodies assessed by dynamic light scattering to rapidly estimate oligomerization states in formulation. The resulting hydrodynamic molecular weight values for infliximab were several-fold greater than its monomeric molecular weight, indicating oligomerization, and the observed state was largely consistent with prior literature. This work proposed a rapid, non-invasive method for assessing protein oligomerization in therapeutic formulations.