P805 The persistence of subcutaneous infliximab is equivalent to intravenous form in patients with inflammatory bowel diseases

Abstract

Abstract Background Switching from intravenous (IV) infliximab to subcutaneous (SC) is a new tool in treating patients with inflammatory bowel disease (IBD). This study aimed to evaluate the persistence and tolerance of SC IFX compared to IV IFX and to study outcomes of patients switched back to IV in a real-life patient cohort. Methods We conducted a retrospective monocentric study involving consecutive patients with IBD treated with maintenance IV IFX. The switch to SC was offered to patients in clinical remission receiving an IFX IV dose ≤ 10mg/kg every ≥ 6 weeks, and with a favorable patient profile (good adherence to IFX IV treatment, no decompensated psychiatric condition). Two groups were compared: a "switched" group receiving SC and a control group remaining on IV IFX due to an unfavorable patient profile or refusal of the switch. Results Among 360 consecutive patients treated by IV IFX, 282 were switched to SC and 78 remained on IV (44 due to refusal and 34 with an unfavorable profile). Both groups were similar in age, sex, and disease type and location; IV IFX dosage and frequency were higher in the IV group. With a median follow-up of 59 (46-67) weeks, SC IFX was discontinued in 28/282 (10%) patients (10 due to relapse, 10 by patient decision, and 8 due to intolerance), whereas it was stopped in 1/78 (1%) IV IFX patient for intolerance (p=0.01). Among the 28 who discontinued SC IFX, 27 reverted to IV, with 4 (1% of the switch group) permanently stopping IFX. Overall, persistence rates for IFX, irrespective of administration route, were comparable between the two groups at 52 weeks: 99% (96-100%) for IV versus 99% (98-100%) for SC (p=0.60). Adverse events were more frequent in the switched group than the control group (10% versus 3%, p=0.03). Primarily, this involved psoriasiform lesions in 9 patients; 4 patients reported an injection site reaction. The proportion of side effects leading to IFX discontinuation or hospitalization was identical in both groups (1 patient, 2%). Conclusion In a real-life cohort, switching from IV to SC IFX does not alter treatment persistence. In cases of poor tolerance to SC IFX, IV IFX re-initiation is effective. Switching to SC IFX is a therapeutic option for patients in remission on IV IFX.