Flixabi™, in combination with methotrexate, is indicated for the reduction of signs and symptoms as well as the improvement in physical function in:
In these patient populations, a reduction in the rate of the progression of joint damage, as measured by X-ray, has been demonstrated (please see section 5.1 of the Summary of Product Characteristics).
Flixabi™ is indicated for:
Flixabi™ is indicated for treatment of severe, active Crohn’s disease in children and adolescents aged 6 to 17 years, who have not responded to conventional therapy including a corticosteroid, an immunomodulator and primary nutrition therapy; or who are intolerant to or have contraindications for such therapies. Flixabi™ has been studied only in combination with conventional immunosuppressive therapy.
Flixabi™ is indicated for treatment of moderately to severely active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy including corticosteroids and 6-mercaptopurine (6-MP) or azathioprine (AZA), or who are intolerant to or have medical contraindications for such therapies.
Flixabi™ is indicated for treatment of severely active ulcerative colitis in children and adolescents aged 6 to 17 years, who have had an inadequate response to conventional therapy including corticosteroids and 6-MP or AZA, or who are intolerant to or have medical contraindications for such therapies.
Flixabi™ is indicated for treatment of severe, active ankylosing spondylitis, in adult patients who have responded inadequately to conventional therapy.
Flixabi™ is indicated for treatment of active and progressive psoriatic arthritis in adult patients when the response to previous DMARD therapy has been inadequate.
Flixabi™ should be administered:
Flixabi™ has been shown to improve physical function in patients with psoriatic arthritis, and to reduce the rate of progression of peripheral joint damage as measured by X-ray in patients with polyarticular symmetrical subtypes of the disease (see section 5.1 of the Summary of Product Characteristics).
Flixabi™ is indicated for treatment of moderate to severe plaque psoriasis in adult patients who failed to respond to, or who have a contraindication to, or are intolerant to other systemic therapy including ciclosporin, methotrexate or psoralen ultra-violet A (PUVA) (see section 5.1 of the Summary of Product Characteristics).
Flixabi™ treatment must be initiated and supervised by qualified physicians experienced in the diagnosis and treatment of rheumatoid arthritis, inflammatory bowel diseases, ankylosing spondylitis, psoriatic arthritis or psoriasis. Flixabi™ should be administered intravenously.
The infusions should be administered by qualified healthcare professionals trained to detect any infusion-related issues.
Patients treated with Flixabi™ should be given the package leaflet and the patient reminder card.
MAINTENANCE THERAPY: shortened infusion as an option in adults after the induction phase
In carefully selected adult patients who have tolerated at least 3 initial 2-hour infusions of FlixabiTM and are receiving maintenance therapy, consideration may be given to administering subsequent infusions over a period of not less than 1 hour. If an infusion reaction occurs in association with a shortened infusion, a slower infusion rate may be considered for future infusions if treatment is to be continued.
Shortened infusions at doses >6 mg/kg have not been studied (see section 4.8 of the SmPC).
Remove flip-top from the vial and wipe the top with a 70% alcohol swab.
Under aseptic conditions, insert the 21G (0.8 mm) or smaller syringe needle into the vial through the centre of the rubber stopper.
Allow 10 ml water for injections to flow down the inner wall of each vial.
Gently swirl the solution by rotating the vial to dissolve the lyophilised powder. Avoid prolonged or vigorous agitation. Do not shake.
Foaming of the solution on reconstitution is not unusual.
Leave the reconstituted solution to stand for 5 minutes.
Checking the solution: It should be colourless to light yellow and opalescent; the solution may develop a few fine translucent particles, as infliximab is a protein.
Do not use if opaque particles, discolouration, or other foreign particles are present.
Dilute the total volume of the reconstituted Flixabi™ solution dose to 250 ml with sodium chloride (NaCl) 0.9% solution for infusion. Do not dilute the reconstituted Flixabi™ solution with any other diluent.
Withdraw a volume from the 250 ml 0.9% NaCl solution equal to the volume of reconstituted Flixabi™ solution(s).
Slowly add the total volume of reconstituted Flixabi™ solution to the 250 ml infusion bottle or bag and gently mix. Please refer to the SmPC, section 6.6 Special precautions for disposal and other handling for volumes greater than 250 ml, either use a larger infusion bag (e.g. 500 ml, 1,000 ml) or use multiple 250 ml infusion bags to ensure that the concentration of the infusion solution does not exceed 4 mg/ml.
Administer the infusion solution over a period of not less than the infusion time recommended (see section 4.2 on Dosing and Administration of the Summary of Product Characteristics).
Use only an infusion set with an in-line, sterile, non-pyrogenic, low protein-binding filter (pore size 1.2 micrometre or less).
Since no preservative is present, it is recommended that the administration of the solution for infusion is to be started as soon as possible and within 3 hours of reconstitution and dilution.
Do not infuse Flixabi™ concomitantly in the same intravenous line with other agents.
Do not store any unused portion of the infusion solution for reuse.