TNF-α¹ is a cytokine² that is instrumental in the inflammatory process of RA³. Besides its role in causing inflammation, TNF-α has also been shown to lead to the death of cells and to the destructive erosions of articular cartilage⁴ that are seen in RA.

Cytokines, like many other types of biologically active substances, are able to work only if they can bind to specifically matched receptors, like keys in locks. Receptors may be found on the surfaces of cells or floating in the serum⁵ of the blood. Any substance that specifically matches the shape of such a biologically active protein can bind to it, rendering it unable to perform its normal job. This is akin to attaching a rubber blade-guard to the blade of an ice skate. The blade-guard specifically matches the shape of the ice skate’s blade, but once attached, it renders the ice skate blade incapable of functioning normally.

TNF-α inhibitors are genetically engineered proteins that bind specifically to the TNF-α of RA patients, thereby inhibiting the biologic activity of the TNF-α, just like putting a blade-guard on an ice skate. TNF-α inhibitors have been shown to substantially reduce the joint destruction seen in RA and to substantially reduce the pain and inflammation of the disease.

Because biologics like Remicade^TM are not chemicals like most medications, they tend not to cause side effects in the liver and kidney, common to many other drugs. Side effects of Remicade^TM include occasional reactions during the infusion which are quickly handled by on-site medical staff, and occasional increased susceptibility to infection. Studies have shown that the incidence of infections is relatively low and outweighed by the benefits of significant suppression of the symptoms, signs, and joint destruction of RA.

TNF-α inhibitors are among the first fruits of the new revolution in genetic medicine. They are made by E. coli bacteria whose chromosomes have had new genes (artificially made by man and similar to viruses) inserted into them by recombinant DNA techniques. These incredible agents, truly at the cutting edge of science, can be compared to the earliest products of the antibiotic era, like penicillin in 1940. Hopefully, the next few years will see similar products capable of arresting other disease processes as effectively as the TNF-α inhibitors have affected RA⁶.

The Arthritis Center of Connecticut is proud to have been in the vanguard of this biological assault on RA, having participated in studies of the effectiveness and safety of Remicade^TM, a brand name TNF-α inhibitor, undertaken to obtain FDA (Food and Drug Administration) approval.

The Arthritis Center serves its Remicade^TM patients in its dedicated Infusion Center. Since Remicade^TM must be administered by intravenous (IV) infusion it is essential to create the most comfortable environment possible. The Infusion Center is staffed by skilled professionals highly experienced in intravenous therapy. Most uncomplicated infusions are completed in less than half the time required by regular hospitals.

[ An RA patient receives a professional reflexology treatment during an infusion.]

The staff of the Infusion Center is trained and experienced in all aspects of IV infusion, including routine and emergency procedures. A physician assistant and a doctor are always on the premises in addition to at least one of our RN infusion specialists and our regular medical assistants. Infusion Center patients are offered refreshments and the services of a professional reflexologist at no charge.

Our billing department takes care of all insurance issues including pre-authorization, even for patients referred by outside physicians. Currently, the Infusion Center serves patients referred by many different doctors and from different states.

The Infusion Center is a pleasant and comfortable setting especially designed to ease the fears of those anticipating a new form of treatment. Every effort is made to make the infusion treatment as pleasant as possible. Besides the care of the patient’s primary disease, the personal privacy and the physical and emotional comfort of our patients are the paramount concerns of our staff. For these reasons we accept transfers from other facilities.

[ Senior rheumatology physician assistant Rick Pope adjusts the infusion rate for a patient with RA.]

In addition to treating RA patients with Remicade^TM, the Infusion Center offers treatment for patients with Crohn’s disease and treatment with other IV medications, including, but not necessarily limited to, Aredia^TM for osteoporosis, InFed^TM for iron deficiency anemia in those who can not tolerate oral iron, and antibiotics.

For more information, patients or their physicians can call the Arthritis Center at 203-755-5555.

¹ Tumor necrosis factor-alpha. A cytokine that helps to kill cells. TNF-α normally kills bad cells, but in abnormal conditions, such as RA, TNF-α can cause inflammation of joints or destruction of cartilage.
² Cytokines are biologically active proteins produced by our cells. There are many different cytokines, some of which are known to be abnormally active in diseases such as RA or cancer.
³ Rheumatoid arthritis.
⁴ Articular cartilage is the type of cartilage that caps the ends of our bones where they meet to form joints. Articular cartilage is essential to the normal function of joints. It is the destruction of articular cartilage that occurs in RA and in other types of arthritis that is primarily responsible for deformities and decreased function.
⁵ Serum is the clear part of the blood, without the red or white cells. Serum contains many essential substances, like antibodies and cytokines.
⁶ Remicade^TM is also approved by the Food and Drug Administration for the treatment of Crohn’s disease, an inflammatory bowel condition. Remicade^TM has enabled many patients to reduce the doses of other toxic drugs, such as steroids.