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. 2025 May 19:S1542-3565(25)00425-2.
doi: 10.1016/j.cgh.2025.04.028. Online ahead of print.

PErsistence and Safety of Subcutaneous Infliximab 1 Year After Switch From Intravenous Route in IBD Patients in REMission

Nicolas Mathieu  1 , Marianne Hupé  2 , Frédéric Heluwaert  3 , Pauline Rivière  4 , Xavier Hébuterne  5 , Antoine Chupin  6 , Vered Abitbol  7 , Guillaume Bouguen  8 , Lucine Vuitton  9 , Jean-Marc Gornet  10 , Céline Montuclard  11 , Stéphane Nancey  12 , Guillaume Cadiot  13 , Pauline Wils  14 , Cyrielle Gilletta  15 , Astrid de Maissin  16 , Romain Altwegg  17 , Elise Chanteloup  18 , Laurianne Plastaras  19 , Philippe Ah Soune  20 , Arnaud Bourreille  21 , Carmen Stefanescu  22 , Philippe Seksik  23 , Marion Simon  24 , Mathieu Uzzan  25 , Pierre Andrau  26 , Cléa Rouillon  27 , Yves Arondel  28 , Anthony Buisson  29 , Laurent Peyrin-Biroulet  30 , Bassirou Mboup  31 , Eric Vicaut  31 , David Laharie  32
Affiliations

PErsistence and Safety of Subcutaneous Infliximab 1 Year After Switch From Intravenous Route in IBD Patients in REMission

Nicolas Mathieu et al. Clin Gastroenterol Hepatol. .

Abstract

Background and aims: Real-life data regarding inflammatory bowel disease (IBD) evolution after switch from intravenous infliximab (IV-IFX) to subcutaneous infliximab (SC-IFX) is necessary. The aim of this prospective multicenter cohort study was to describe the persistence, effectiveness and tolerance of SC-IFX after switch from IV-IFX.

Methods: IBD patients in steroid-free clinical remission for at least 6 months on IV-IFX were enrolled in a prospective national French cohort when they switched to SC-IFX. Patients were assessed at inclusion and at weeks 12, 24, and 48. The primary endpoint was the persistence of SC-IFX at week 48. Secondary endpoints comprised steroid-free clinical remission at week 48, IV-IFX switch-back rate, and evolution of infliximab levels during the study period.

Results: Among the 426 patients included (72.4% with Crohn's disease , 27.5% with ulcerative colitis; 45.1% female; median age 37 [interquartile range, 29-50] years; median disease duration of 12 years in Crohn's disease, 13 years in ulcerative colitis), 56% were on IV-IFX standard dosing (5 mg/kg 8-weekly) and 16% received combination therapy with an immunomodulator drug at baseline. At week 48, SC-IFX persistence was 95.4% (95% confidence interval, 93.3%-97.5%) and 86.9% of patients were on steroid-free clinical remission. Mean infliximab levels were 8.0 μg/mL at inclusion and 18.0 μg/mL at week 48 (P < .0001). Among the 19 (4.5%) patients who stopped SC-IFX, 6 (1.4%) switched back to IV-IFX. There were 222 adverse events reported in 42.4% of patients, and 12 led to treatment discontinuation, including 6 (1.4%) severe adverse events.

Conclusions: In this large multicenter prospective cohort, persistence at 1 year of SC-IFX was more than 95% of IBD patients switched in remission from IV-IFX, confirming excellent effectiveness and tolerance of SC-IFX.

Keywords: Inflammatory Bowel Disease; Subcutaneous Infliximab; Switch.

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