Ogled vira Infliksimab

{{drugbox
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| INN               = 
| image             = Infliximab_structure2.jpg
| width             = 
| alt               = 
| caption           = 
<!-- Monoclonal antibody data -->
| type = mab
| mab_type = mab
| source = xi/o
| target = [[Dejavnik tumorske nekroze|TNF]]
<!-- Clinical data -->
| pronounce         = 
| tradename         = Remicade, Remsima, Inflectra, Zessly in drugi
| Drugs.com         = {{drugs.com|monograph|infliximab}}
| MedlinePlus       = 
| licence_CA        = <!-- Health Canada may use generic or brand name (generic name preferred) -->
| licence_EU        = yes
| DailyMedID        = Infliximab
| licence_US        = Infliximab
| pregnancy_AU      = C
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{navedi splet | title=Infliximab Use During Pregnancy | website=Drugs.com | date=2 July 2019 | url=https://www.drugs.com/pregnancy/infliximab.html | access-date=13. 8. 2020}}</ref>
| pregnancy_US      = N
| pregnancy_US_comment = <ref name="Drugs.com pregnancy" />
| pregnancy_category= 
| dependency_liability = 
| addiction_liability = 
| routes_of_administration = [[intravenska pot uporabe|intravensko]] (IV)
| class             = 
| ATCvet            = 
| ATC_prefix        = L04
| ATC_suffix        = AB02
| ATC_supplemental  = 
<!-- Legal status -->
| legal_AU = S4
| legal_AU_comment = 
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| legal_CA = Rx-only
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| legal_DE = <!-- Anlage I, II, III or Unscheduled-->
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| legal_US_comment = 
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| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
| legal_UN_comment = 
| legal_status      = <!--For countries not listed above-->
<!-- Pharmacokinetic data -->
| bioavailability   = 92 % (i.v., zaradi 8-odstotnega zaostanka v brizgi)
| protein_bound     = 
| metabolism        = [[retikuloendotelni sistem]] 
| metabolites       = 
| onset             = 
| elimination_half-life = 9,5 dneva
| duration_of_action = 
| excretion         = 
<!-- Identifiers -->
| CAS_number_Ref    = {{cascite|correct|??}}
| CAS_number        = 170277-31-3
| CAS_supplemental  = 
| PubChem           = 
| IUPHAR_ligand     = 
| DrugBank_Ref      = {{drugbankcite|correct|drugbank}}
| DrugBank          = DB00065
| ChemSpiderID_Ref  = {{chemspidercite|changed|chemspider}}
| ChemSpiderID      = none
| UNII_Ref          = {{fdacite|correct|FDA}}
| UNII              = B72HH48FLU
| KEGG_Ref          = {{keggcite|correct|kegg}}
| KEGG              = D02598
| ChEBI_Ref         = 
| ChEBI             = 
| ChEMBL_Ref        = {{ebicite|changed|EBI}}
| ChEMBL            = 1201581
| NIAID_ChemDB      = 
| PDB_ligand        = 
| synonyms          = infliksimab-abda, infliksimab-axxq, infliksimab-dyyb, infliksimab-qbtx
<!-- Chemical and physical data -->
| IUPAC_name        = 
| C=6428 | H=9912 | N=1694 | O=1987 | S=46
| SMILES            = 
| StdInChI          = 
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}}

<!-- Opredelitev in medicinska uporaba -->
'''Inflíksimàb''' je [[monoklonsko protitelo]] proti [[TNF-alfa]], ki se uporablja pri zdravljenju [[revmatoidni artritis|revmatoidnega artritisa]], [[crohnova bolezen|crohnove bolezni]], [[ulcerozni kolitis|ulceroznega kolitisa]], [[ankilozirajoči artritis|ankilozirajočega artritisa]], [[luskavica|luskavice]], [[psoriatični artritis|psoriatičnega artritisa]] in [[behçetova bolezen|behçetove bolezni]].<ref name=SMS>https://www.termania.net/slovarji/slovenski-medicinski-slovar/5520362/infliksimab?query=infliksimab&SearchIn=All Slovenski medicinski e-slovar, vpogled: 15. 9. 2020.</ref><ref name=AHFS2019/> Daje se [[intravenska pot uporabe|intravensko]], običajno v šest- do osemtedenskih razmikih.<ref name=AHFS2019/>

<!-- Neželeni učinki in mehanizem delovanja-->
Med pogoste [[neželeni učinek|neželene učinke]] spadajo [[okužba|okužbe]], [[akutna infuzijska reakcija]] in [[bolečina v trebuh]]u.<ref name=AHFS2019/> Gre za [[biološko zdravilo]] iz skupine [[himerna beljakovina|himernih]] (mišje-človeških) monoklonskih protiteles, ki se vežejo na [[dejavnik tumorske nekroze alfa]] (TNF-α), in sicer na njegovo topno kot transmembransko obliko TNF.<ref name=SMS/><ref name=Jakopovic>Jakopovič K. Zdravila za zdravljenje Crohnove bolezni in ulceroznega kolitisa. Farm vestn 2017; 68: 267–272.</ref>

Infliksimab je pridobil dovoljenje za promet z zdravilom v ZDA leta 1998,<ref name=AHFS2019>{{navedi splet |title=Infliximab, Infliximab-dyyb Monograph for Professionals |url=https://www.drugs.com/monograph/infliximab-infliximab-dyyb.html |website=Drugs.com |publisher=American Society of Health-System Pharmacists |access-date=15. 7. 2019 }}</ref> v Evropski uniji pa leta 1999.<ref>{{navedi splet | title=Remicade EPAR | website=[[Evropska agencija za zdravila]] (EMA) | date=17. 9. 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/remicade | access-date=2. 4. 2020}}</ref> Zaradi poteka patenta so na tržišču že tudi [[podobno biološko zdravilo|podobna biološka zdravila]], v Evropski uniji od 2013, v ZDA od leta 2016.<ref name="Renflexis approval">{{navedi splet | title=Renflexis: FDA Approved Drug Products | website=U.S. [[Food and Drug Administration]] (FDA) | date=17. 4. 2019 | url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761054 | archive-url=https://web.archive.org/web/20190417115642/https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761054 | archive-date=17. 4. 2019 | url-status=unfit | access-date=6. 12. 2019}} {{PD-notice}}</ref><ref name="Ixifi approval">{{navedi splet | title=Ixifi: FDA-Approved Drugs | website=U.S. [[Food and Drug Administration]] (FDA) | date=6. 12. 2019 | url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761072 | archive-url=https://web.archive.org/web/20191207000754/https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761072 | archive-date=7. 12. 2019 | url-status=live | access-date=6. 12. 2019}} {{PD-notice}}</ref><ref name="Avsola approval">{{navedi splet | title=Avsola: FDA-Approved Drugs | website=U.S. [[Food and Drug Administration]] (FDA) | date=6. 12. 2019 | url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761086 | archive-url=https://web.archive.org/web/20191207000021/https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=761086 | archive-date=7. 12. 2019 | url-status=live | access-date=6. 12. 2019}} {{PD-notice}}</ref>

== Klinična uporaba ==
Infliksimab je odobren za zdravljenje:<ref>https://www.ema.europa.eu/en/documents/product-information/remicade-epar-product-information_sl.pdf Povzetek glavnih značilnosti zdravila Remicade, vpogled: 16. 9. 2020.</ref><ref name="Maxwell">{{cite journal|last1=Maxwell|first1=LJ|last2=Zochling|first2=J|last3=Boonen|first3=A|last4=Singh|first4=JA|last5=Veras|first5=MM|last6=Tanjong Ghogomu|first6=E|last7=Benkhalti Jandu|first7=M|last8=Tugwell|first8=P|last9=Wells|first9=GA|title=TNF-alpha inhibitors for ankylosing spondylitis.|journal=The Cochrane Database of Systematic Reviews|date=18. 4.  2015|volume=4|issue=4|pages=CD005468|pmid=25887212|doi=10.1002/14651858.CD005468.pub2|url=http://ecite.utas.edu.au/120128}}</ref><ref>{{cite journal|last1=Blumenauer|first1=Barbara BTB|last2=Judd|first2=Maria|last3=Wells|first3=George A|last4=Burls|first4=Amanda|last5=Cranney|first5=Ann|last6=Hochberg|first6=Marc C|last7=Tugwell|first7=Peter|last8=Lopez-Olivo|first8=Maria Angeles|date=22. 7. 2022|title=Infliximab for the treatment of rheumatoid arthritis|journal=Cochrane Database of Systematic Reviews|issue=3|pages=CD003785|doi=10.1002/14651858.cd003785|pmid=12137712|issn=1465-1858}}</ref>
* [[crohnova bolezen|crohnove bolezni]]
* [[ulcerozni kolitis|ulceroznega kolitisa]]
* [[ankilozirajoči artritis|ankilozirajočega artritisa]], 
* [[luskavica|luskavice]] in
* [[psoriatični artritis|psoriatičnega artritisa]].

[[Nenamenska uporaba zdravila|Nenamensko]] se uporablja tudi za zdravljenje [[behçetova bolezen|behçetove bolezni]].<ref>{{cite journal | vauthors = Sfikakis PP | title = Behçet's disease: a new target for anti-tumour necrosis factor treatment | journal = Ann. Rheum. Dis. | volume = 61 Suppl 2 | issue = Suppl 2 | pages = ii51–3 | date = november 2002 | pmid = 12379622 | pmc = 1766720 | doi = 10.1136/ard.61.suppl_2.ii51 }}</ref>

== Mehanizem delovanja ==
Infliksimab je [[biološko zdravilo]] iz skupine [[himerna beljakovina|himernih]] (mišje-človeških) monoklonskih protiteles, ki se vežejo na [[dejavnik tumorske nekroze alfa]] (TNF-α), in sicer na njegovo topno kot transmembransko obliko TNF.<ref name=SMS/><ref name="Jakopovic"/> Z vezavo topnega TNF-α neposredno zavirajo njegovo provnetno delovanje na številne imunske celice, z vezavo na membransko vezani TNF-α pa povzročajo [[apoptoza|apoptozo]] imunskih celic, spodbujajo s [[Sistem komplementa|komplementom]] in protitelesi posredovano citotoksičnost ter zavirajo izločanje [[citokin]]ov.<ref name=Jakopovic/>

== Sklici ==
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{{normativna kontrola}}
[[Kategorija:Monoklonska protitelesa]]
[[Kategorija:Antirevmatiki]]
[[Kategorija:Zaviralci TNF-alfa]]