Persistence of subcutaneous versus intravenous infliximab in a real-life cohort: A propensity-score matched comparative analysis

• Published in: Digestive and liver disease 2024-10
• Main Authors: Bothorel, L., Laharie, D., Poullenot, F., Gohier, E., Chevrier, C., Berger, A., Zerbib, F., Rivière, P.
• Format: Article
• Language: English
• Subjects: Crohn's disease; Inflammatory bowel disease; Infliximab; Switch; Switchback; Ulcerative colitis
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2024.09.015

There is limited comparative data on patients with inflammatory bowel disease (IBD) switched from intravenous to subcutaneous infliximab and those continuing intravenously. This study aimed to compare the persistence and tolerance of subcutaneous and intravenous infliximab and the outcomes of patients resuming intravenous infliximab. We conducted a retrospective single-centre cohort study involving IBD patients treated with maintenance intravenous infliximab. The switch to subcutaneous infliximab was offered to patients in clinical remission receiving an intravenous dose ≤ 10 mg kg-1 every ≥ 6 weeks. The switch group was compared to controls remaining on intravenous infliximab due to refusal of the switch. With a median follow-up of 59 (46–67) weeks, subcutaneous infliximab was discontinued in 28/282 (10 %) patients and intravenous infliximab in 1/78 (1 %) patient (p = 0.01); after propensity score-matching of the two cohorts, persistence rates at 52 weeks were respectively 91 % (95 % CI 84–98) and 100 % (95 % CI 100–100, p = 0.01). Among the 28 who discontinued subcutaneous infliximab, 27 resumed intravenous infliximab, with 4 (1 % of the switch group) who permanently stopped infliximab. Switching from intravenous to subcutaneous infliximab led to a lower treatment persistance. In cases of poor tolerance or relapse under subcutaneous infliximab, resuming intravenous infliximab is effective.