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August 21, 2025Journal of Clinical Gastroenterology3 citations

Effectiveness of Switching From Intravenous to Subcutaneous Infliximab in Patients With Inflammatory Bowel Disease

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FCFraser CummingsSouthampton General HospitalPSPhilip J SmithDesmond Tutu HIV FoundationMFMathurin FuméryCentre Hospitalier Universitaire Amiens-Picardie

Key Points

  • Clinical remission was maintained in 84.7% of patients at 6 months after switching treatments.
  • Of 428 patients, 85.4% were in remission at baseline, showing a slight decrease by 6 months with a clear distinction between Crohn's disease and ulcerative colitis.
  • Observational meta-analysis combined data from three cohorts to evaluate disease activity, pharmacokinetics, and biomarkers related to infliximab treatment.
  • Switching strategies indicate minimal drug discontinuation rate at 5.8%, reinforcing the effectiveness of the transition for IBD patients.

Abstract

Goals: We assessed clinical outcomes over 6 months in an integrated analysis of inflammatory bowel disease (IBD) patients switching from intravenous (IV) to subcutaneous (SC) infliximab (IFX). Background: Real-world data from large multinational IBD patient populations treated with SC IFX are lacking. Study: This individual participant data meta-analysis combined anonymized data from 3 real-world cohorts and evaluated clinical remission Crohn’s disease (CD): Harvey-Bradshaw Index (HBI)/modified HBI (mHBI) <5; ulcerative colitis (UC): Simple Clinical Colitis Activity Index (SCCAI)/partial Mayo score (PMS) <3, disease activity (HBI/mHBI/SCCAI/PMS), treatment persistence, pharmacokinetics, immunogenicity, biomarkers fecal calprotectin (FCP); C-reactive protein (CRP), and reasons for discontinuation. Subgroup analyses determined the effect of clinical parameters on outcomes. Results: Of 428 patients (CD, n=302; UC, n=126), 85.4% were in clinical remission at baseline, which was maintained at 6 months (84.7%), and was higher in patients with CD versus UC (89.8% vs. 71.9%; P <0.001); disease activity scores remained low. High treatment persistence was observed (94.5%) at 6 months. Median serum IFX levels increased from 5.6 μg/mL at baseline to 16.0 μg/mL at 6 months. Most patients (96.1%) maintained negative antidrug antibody status and low levels of FCP and CRP up to 6 months. Drug discontinuation rate was low (5.8%). Intensified preswitch IV IFX was the only factor negatively associated with CD remission at 6 months intensified vs. standard estimated marginal mean probability difference −0.107 (95% CI: −0.191, −0.024); P =0.012. Conclusions: Switching from IV to SC IFX maintains clinical effectiveness in patients with IBD regardless of various patient factors.

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Cite This Study

Cummings et al. (2025) studied this question.

synapsesocial.com/papers/68a6fb955502675167ba9381https://doi.org/10.1097/mcg.0000000000002228
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