I am doing well on Remicade and Celebrex. Do you have to take methotrexate if you are on Remicade?

Ask the Doctor - Questions about Rheumatoid Arthritis


Stephen A. Paget, MD, FACP, FACR

Physician-in-Chief and Chairman of the Division of Rheumatology, Hospital for Special Surgery
The Joseph P. Routh Professor of Medicine, Weill Medical College of Cornell University


I am doing well on Remicade and Celebrex. Do you have to take methotrexate if you are on Remicade?

Answer: The FDA indication for Remicade indicates that patients should also be on methotrexate. This is because methotrexate appears to decrease the immunological response of the body to the mouse component of the Remicade. Remicade is called a chimera protein which means that it is made up of three-quarters human protein and one quarter mouse. This reaction can manifest itself as a decreased responsiveness to the Remicade and/or an allergic reaction to the infusion in the form of fever or shortness of breath. However, some patients seem to do fine off of methotrexate. It must be noted that a recent trial that studied the efficacy of Enbrel (another anti-TNF medication) plus methotrexate led to fewer joint erosions and improved clinical outcome than that seen with Enbrel alone.

posted 8/11/2004