Subcutaneous infliximab shows promise in UK IBD study

A retrospective study, the largest of its kind in the UK, has unveiled promising results in the use of subcutaneous (SC) infliximab for treating inflammatory bowel disease (IBD), challenging the conventional intravenous (IV) administration of the drug. The study aimed to fill the data gap by comparing SC and IV infliximab, particularly focusing on patients who have been receiving the IV formulation for an extended period.

Although SC infliximab has been studied as an alternative to IV infliximab to maintain remission in patients with IBD, SC infliximab in high-risk patients or in those who had been treated with IV infliximab for a long period has not yet been evaluated. The current retrospective cohort study involved 306 participants in clinical remission, either high-risk patients or patients who had been on IV infliximab for a longer duration [1]. The efficacy, pharmacokinetics, and safety of SC infliximab were analysed compared with its IV counterpart. The study assessed objective biomarkers and clinical disease activity scores, ensuring a comprehensive evaluation of the drug’s performance over various periods.

The participants on SC infliximab demonstrated remarkable treatment persistence, with an 87% rate compared with 35% in the IV group (P<0.001). The SC infliximab group also exhibited a significant increase in drug levels (OR 31.77; P=0.001) and a decrease in treatment discontinuation rate due to anti-drug antibody formation (2% vs 20%, in the SC and IV groups, respectively) and side effects (3% vs 13%, respectively).

The findings advocate considering SC infliximab as a viable and effective alternative for patients in established clinical remission on IV infliximab. One of the researchers elaborated on the study’s findings: "Subcutaneous switch should be considered in patients in established clinical remission on IV infliximab as offering an effective and safe alternative in IBD. Subcutaneous switch should even be considered in those high-risk patient groups." The SC route has shown favourable pharmacokinetic properties, heralding a new era in the personalised-treatment approach in IBD.

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   1. Mahmood T, et al. A retrospective cohort study to compare the efficacy, pharmacokinetics and safety of subcutaneous (SC) and intravenous (IV) infliximab in the treatment of inflammatory bowel disease. LB02, UEG Week 2023, 14–17 October, Copenhagen, Denmark.

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Posted on 7 December 20238 April 2024