Effectiveness of Switching From Intravenous ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Effectiveness of Switching From Intravenous to Subcutaneous Infliximab in Patients With Inflammatory Bowel Diseases: the REMSWITCH Study.
Author(s) :
Buisson, Anthony [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Reymond, Maud [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Yzet, Clara [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Wils, Pauline [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Payen, Laure [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Laugie, Marie [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Manlay, Luc [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Mathieu, Nicolas [Auteur]
Université Grenoble Alpes [2016-2019] [UGA [2016-2019]]
Pereira, Bruno [Auteur]
Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] [DRCI]
Fumery, Mathurin [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Reymond, Maud [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Yzet, Clara [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Wils, Pauline [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Payen, Laure [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Laugie, Marie [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Manlay, Luc [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Mathieu, Nicolas [Auteur]
Université Grenoble Alpes [2016-2019] [UGA [2016-2019]]
Pereira, Bruno [Auteur]
Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] [DRCI]
Fumery, Mathurin [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Journal title :
Clinical Gastroenterology and Hepatology
Abbreviated title :
Clin Gastroenterol Hepatol
Volume number :
21
Pages :
2338-2346
Publication date :
2022-09-20
ISSN :
1542-7714
English keyword(s) :
Crohn's Disease
Ulcerative Colitis
Infliximab
Subcutaneous
Switch
Trough Level
Ulcerative Colitis
Infliximab
Subcutaneous
Switch
Trough Level
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background and Aims
We assessed the effectiveness of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel diseases (IBDs) treated with or without intensified intravenous regimen.
Methods
In ...
Show more >Background and Aims We assessed the effectiveness of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel diseases (IBDs) treated with or without intensified intravenous regimen. Methods In this multicenter observational study, IBD patients in clinical remission (partial Mayo score ≤2 or Harvey-Bradshaw index ≤4) were switched to a unique dose of subcutaneous infliximab (120 mg every other week). Pharmacological and biological data were collected at baseline, visit 1 (4–8 weeks postswitch), visit 2 (8–16 weeks postswitch), and visit 3 (16–24 weeks postswitch). Relapse was defined as clinical relapse or fecal calprotectin increase ≥150 μg/g compared with baseline. Results Among 184 eligible patients, 72.3% (n = 133 of 184) agreed to switch to subcutaneous infliximab. At visit 3, a relapse occurred in 10.2% (n = 6 of 59), 7.3% (n = 3 of 38), 16.7% (n = 3 of 18), and 66.7% (n = 10 of 15) (P < .001) of patients receiving 5 mg/kg every 8 weeks, 10 mg/kg every 8 weeks, 10 mg/kg every 6 weeks, and 10 mg/kg every 4 weeks, respectively. Dose escalation to 240 mg every other week led to recapture clinical remission in 93.3% (n = 14 of 15). Infliximab serum levels increased after the switch (P < .0001) except for patients receiving 10 mg/kg every 4 weeks. In multivariable analysis, 10 mg/kg every 4 weeks regimen (odds ratio, 12.4; 95% confidence interval, 1.6–98.4; P = .017) and fecal calprotectin >250 μg/g at baseline (odds ratio, 5.4; 95% confidence interval, 1.1–27.6; P = .042) had a higher risk of relapse as well as reduced (41.7%) or stable (36.8%) infliximab serum levels between baseline and visit 1 compared with increased serum levels (12.7%) (P = .020 and P = .019, respectively). Patients’ acceptability (10-point scale) was improved by the switch (6.9 ± 1.6 vs 8.6 ± 1.4; P < .0001). No severe adverse event was reported. Conclusions Switching from intravenous to subcutaneous infliximab 120 mg every other week is safe and well accepted, leading to a low risk of relapse in IBD patients except for those receiving 10 mg/kg every 4 weeks requiring 240 mg every other week.Show less >
Show more >Background and Aims We assessed the effectiveness of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel diseases (IBDs) treated with or without intensified intravenous regimen. Methods In this multicenter observational study, IBD patients in clinical remission (partial Mayo score ≤2 or Harvey-Bradshaw index ≤4) were switched to a unique dose of subcutaneous infliximab (120 mg every other week). Pharmacological and biological data were collected at baseline, visit 1 (4–8 weeks postswitch), visit 2 (8–16 weeks postswitch), and visit 3 (16–24 weeks postswitch). Relapse was defined as clinical relapse or fecal calprotectin increase ≥150 μg/g compared with baseline. Results Among 184 eligible patients, 72.3% (n = 133 of 184) agreed to switch to subcutaneous infliximab. At visit 3, a relapse occurred in 10.2% (n = 6 of 59), 7.3% (n = 3 of 38), 16.7% (n = 3 of 18), and 66.7% (n = 10 of 15) (P < .001) of patients receiving 5 mg/kg every 8 weeks, 10 mg/kg every 8 weeks, 10 mg/kg every 6 weeks, and 10 mg/kg every 4 weeks, respectively. Dose escalation to 240 mg every other week led to recapture clinical remission in 93.3% (n = 14 of 15). Infliximab serum levels increased after the switch (P < .0001) except for patients receiving 10 mg/kg every 4 weeks. In multivariable analysis, 10 mg/kg every 4 weeks regimen (odds ratio, 12.4; 95% confidence interval, 1.6–98.4; P = .017) and fecal calprotectin >250 μg/g at baseline (odds ratio, 5.4; 95% confidence interval, 1.1–27.6; P = .042) had a higher risk of relapse as well as reduced (41.7%) or stable (36.8%) infliximab serum levels between baseline and visit 1 compared with increased serum levels (12.7%) (P = .020 and P = .019, respectively). Patients’ acceptability (10-point scale) was improved by the switch (6.9 ± 1.6 vs 8.6 ± 1.4; P < .0001). No severe adverse event was reported. Conclusions Switching from intravenous to subcutaneous infliximab 120 mg every other week is safe and well accepted, leading to a low risk of relapse in IBD patients except for those receiving 10 mg/kg every 4 weeks requiring 240 mg every other week.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Submission date :
2024-01-12T00:49:22Z
2024-03-04T14:47:36Z
2024-03-04T14:47:36Z