Abstract
Tumor necrosis factor (TNF) inhibitors were shown to be more effective than single methotrexate (MTX) as a treatment for patients with newly-diagnosed rheumatoid arthritis (RA). Infliximab, one of the TNF inhibitors of chimeric monoclonal antibody against TNFα, has been demonstrated to decrease disease activity which leads to a complete remission, and the protection of joint destruction in early RA patients with MTX medication. Furthermore, several reports indicate that some of these patients maintain a complete remission (CR) after the injection of infliximab is stopped if MTX medication is continued.
This paper presents a case in which a 69-year-old female patient with RA continues CR for more than 18 months after stopping infliximab injections even though the MTX medication is continued. The patient has a 17-year history of RA, and advanced joint destruction, in stage IV. This case, therefore, suggests the possibility that infliximab may be stopped even in an advanced condition of RA if the CR is continued. This case also suggests that an indication of infliximab for patients with RA may be expanded for elderly patients and more advanced disease conditions.
