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TOPLINE:

Switching from established intravenous (IV) therapy to subcutaneous infliximab was associated with high treatment persistence, stable clinical disease activity, and consistent faecal calprotectin levels in patients with inflammatory bowel disease (IBD).

METHODOLOGY:

• Researchers conducted a retrospective study at two Finnish tertiary care centres to assess treatment persistence, clinical outcomes, safety, and drug levels after switching from IV to subcutaneous infliximab in patients with IBD.
• They included 274 patients with IBD: 104 with Crohn's disease (median age, 37.5 years; 35.6% women) and 170 with ulcerative colitis (median age, 37 years; 34.7% women). These patients were in clinical remission on a maintenance dose of IV infliximab and switched to subcutaneous infliximab CT-P13 therapy, with follow-up data collected over a median of 79 weeks.
• IV maintenance therapy was defined as at least 3 months of established treatment, while subcutaneous therapy involved 120 mg injections every 7, 10, or 14 days, with adjustments according to clinical judgment.
• Infliximab concentrations were measured before and after the switch, with IV trough levels recorded within 3 months prior and subcutaneous levels assessed 3-6 months after the switch.
• Clinical disease activity was assessed using the Harvey-Bradshaw Index for Crohn's disease and the Partial Mayo Score for ulcerative colitis. Patient-reported outcomes were used to estimate the effects of IBD on patients' everyday lives, and faecal calprotectin levels (< 100 mg/g) were assessed to indicate inactive disease.

TAKEAWAY:

• Subcutaneous infliximab therapy resulted in a high treatment persistence rate of 94.8% in patients with Crohn's disease and 88.8% in patients with ulcerative colitis at 12 months.
• Clinical disease activity and faecal calprotectin levels remained stable, with no significant changes observed at 3, 6, and 12 months post-switch. Median scores for patient-reported outcomes also remained unchanged.
• Infliximab concentrations were significantly higher during subcutaneous administration than at baseline during IV treatment (median, 16.75 vs 6.71 μg/mL; P < .0001). During follow-up, 93.1% of patients were corticosteroid free, whereas 6.9% required corticosteroid therapy.
• Mild adverse events were reported by 13.5% of patients, and serious adverse events were reported by 1.5%. Two infections that required hospitalisation were reported, and two patients with ulcerative colitis were hospitalised due to disease flare-ups.

IN PRACTICE:

"These results encourage switching from IV IFX [infliximab] maintenance therapy to self-administered SC [subcutaneous] therapy in the treatment of patients with IBD," the authors wrote.

SOURCE:

The study was led by Jaakko Rautakorpi, University of Turku and Turku University Hospital, Turku, and Sara Kolehmainen, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. It was published online on February 13, 2025, in Digestive Diseases and Sciences.

LIMITATIONS:

The study did not include a control group that continued IV therapy. The retrospective design limited the availability of clinical faecal calprotectin and endoscopic data at specific time points. Only patients who completed the switch were included, with those who continued IV treatment excluded, limiting the ability to report reasons for not switching.

DISCLOSURES:

Open access funding provided by the University of Turku was reported. Some authors reported receiving support for meeting attendance, as well as travel expenses, speaker and consultant fees, and research grants from various sources. One author reported participating in planning educational meetings and being a shareholder in a pharmaceutical company.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.