Abstract Konstantinos Μousourakis Fotios Fousekis Konstantinos Mpakogiannis Anastasios Koukoudis Myrto Cheila Eirini Ζacharopoulou Maria Palatianou Anastasia Katsoula Nikolaos Kyriakos Evgenia Papathanasiou Evangelia Mole Dimitrios Vasilopoulos Nikos Michalakeas Marina Papoutsaki Vasiliki Chasapi Alexandros Stratigos Background To assess whether obesity affects the efficacy of elective switching from intravenously (IV) to subcutaneously (SC) administered infliximab (IFX) in patients with immune-mediated diseases. Methods A retrospective analysis was conducted of patients with Crohn’s disease (CD), Ulcerative Colitis (UC), Spondyloarthritis (SpA), Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and chronic plaque Psoriasis (PsO) who were receiving infliximab intravenously (IFX-IV) for maintenance of remission in tertiary referral centres and were switched to subcutaneous infliximab (IFX-SC) based on their physician’s choice. All patients with gastrointestinal and skin diseases were in clinical remission, while those with musculoskeletal disease had inactive disease or low disease activity. Outcomes of IFX-SC treatment, including disease worsening according to disease-specific composite measures, occurrence of adverse events, and rates of treatment discontinuation, were compared between normal-weight patients and those who were overweight (BMI 25–29.9) or obese (BMI ≥30) at the time of IFX switch. Results Between April 2023 and April 2024, a total of 344 patients (CD = 136, UC = 62, SpA = 52, PsA = 38, RA = 7, PsO = 44, co-existence of more than one disease = 5) were switched from IFX-IV to IFX-SC. After a mean ± SD follow-up period of 8 ± 4 months, 12 patients (3.5%) discontinued treatment with IFX-SC: five (1.5%) due to disease worsening and seven (2.0%) due to the occurrence of adverse events. The remaining 332 patients (96.5%) showed a favourable response, none required an unscheduled visit, developed clinical or laboratory adverse events, or needed escalation of treatment. Among study participants, 43 (12.5%) were obese and 81 (23.5%) were overweight. The rates of disease worsening (2/124 vs 10/220, p = 0.15) did not differ between obese or overweight patients compared with normal-weight patients. Conclusion Elective switching from IFX-IV to IFX-SC appears to be an effective and safe approach in real-world, everyday clinical practice to maintain long-term clinical remission, inactive disease, or low disease activity in patients with immune-mediated diseases, and it is not affected by obesity. Conflict of interest: Viazis, Nikolaos: Nothing to declare Karamanakos, Anastasios: No conflict of interest Christidou, Angeliki: No conflict of interest Katsanos, Konstantinos: No conflict of interest Christodoulou, Dimitrios: No conflict of interest Tzouvala, Maria: No conflict of interest Giouleme, Olga: No conflict of interest Liatsos, Christos: No conflict of interest Zampeli, Evanthia: No conflict of interest Theodoropoulou, Angeliki: No conflict of interest Karmiris, Konstantinos: No conflict of interest Trimponias, Georgios Dimitrios: No conflict of interest Mr. Kanellopoulos, Panagiotis: No conflict of interest Gazi, Souzana: No conflict of interest Dimitroulas, Athanasios: No conflict of interest Koutsianas, Christos: No conflict of interest Fragoulis, Georgios: No conflict of interest Papagoras, Charis: No conflict of interest Panagakis, Pantelis: No conflict of interest Katsikas, Georgios: No conflict of interest
Viazis et al. (Thu,) studied this question.