Real-world experience with subcutaneous infliximab: broadening treatment strategies for inflammatory bowel disease

Expert Rev Clin Immunol. 2023 Jul-Dec;19(9):1143-1156. doi: 10.1080/1744666X.2023.2231148. Epub 2023 Aug 13.

Abstract

Introduction: The first subcutaneous (SC) formulation of infliximab (IFX), CT‑P13 SC, has been approved in Europe and Australia, including for the treatment of inflammatory bowel disease (IBD).

Areas covered: We provide a comprehensive overview of available clinical trial and real-world data for IFX SC treatment of IBD, focusing on the potential benefits of switching from IFX intravenous (IV) to IFX SC. We evaluate emerging evidence for IFX SC treatment for difficult-to-treat IBD, use as monotherapy, and suitability for patients receiving escalated IFX IV doses. Therapeutic drug monitoring approaches and patient and healthcare system perspectives on IFX SC are also discussed.

Expert opinion: IFX SC represents a significant treatment innovation in the tumor necrosis factor inhibitor class after approximately 20 years of IFX IV availability. Evidence suggests that IFX SC is well tolerated and is associated with high patient acceptance and satisfaction. In addition, effectiveness is maintained in patients with stable disease following switch from IFX IV. Switching may be advisable, given the clinical benefits of IFX SC and its potential to improve healthcare service capacity. There are several areas requiring further research, including the role of IFX SC in difficult-to-treat and refractory disease, and the feasibility of IFX SC monotherapy.

Keywords: Anti-TNF; Crohn’s disease; biologics; inflammatory bowel disease; infliximab; subcutaneous; ulcerative colitis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colitis, Ulcerative* / drug therapy
  • Crohn Disease* / drug therapy
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Infliximab / therapeutic use
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors / therapeutic use

Substances

  • Infliximab
  • Tumor Necrosis Factor Inhibitors