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REMSWITCH Study Finds Low Risk of Relapse With SC Infliximab
Patients with inflammatory bowel disease (IBD) may switch from intravenous (IV) to subcutaneous (SC) infliximab without the risk of adverse events and with low risk of clinical relapse, according to results of the REMSWITCH study, published in Clinical Gastroenterology and Hepatology.
“Infliximab was the first-in-class biologic in inflammatory bowel disease, and it demonstrated the greatest evidence of efficacy in these patients,” the authors noted in the report. Through the the study, the authors evaluated the effectiveness of switching from IV to SC infliximab in patients with IBD as well as assess the subsequent risk of clinical relapse.
The team compiled data from 133 patients with IBD in clinical remission for this multicenter observational study. All patients switched from IV to SC infliximab (120 mg every other week [eow]) and were followed for 3 different visits after the switch at 4-8 weeks, 8-16 weeks, and 16-24 weeks. For the purposes of the study, “relapse was defined as clinical relapse or faecal calprotectin increase ≥ 150 μg/g compared to baseline.”
The following observations were reported:
- At visit 3, the rate of relapse for patients treated with 5mg/kg every 8 weeks was 10.2%, 7.3% for those receiving 10mg/kg every 8 weeks, and 16.7% for patients treated with 10mg/kg every 6 weeks. However, the rate of relapse for patients treated with 10 mg/kg every 4 weeks was 66.7%.
- Concomitantly, the serum levels of infliximab increased for all patient groups after the switch, except for those receiving 10mg/kg every 4 weeks.
- Patients who received 10mg/kg every 4 weeks experienced a higher risk of clinical relapse as well as reduced serum levels of infliximab.
- Among the other subgroups, acceptability of subcutaneous infliximab among patients on a 10-point scale was generally better after the switch.
- None of the patient groups reported a severe adverse event.
“Switching from IV to SC infliximab 120 mg eow is safe and well-accepted leading to a low risk of relapse in IBD patients except for those receiving 10mg/kg/4weeks requiring 240 mg eow,” the researchers concluded.
—Priyam Vora
Reference:
Buisson A, Nachury M, Reymond M et al. Effectiveness of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel diseases: the REMSWITCH study. Clin Gastroenterol Hepatol.2023; 21(9):2338-2346. DOI: https://doi.org/10.1016/j.cgh.2022.08.011
