Crohn's & colitis 360 · 2026
Real-world outcomes of subcutaneous infliximab in a Middle Eastern inflammatory bowel disease cohort: a prospective study of switch and de novo treatment strategies.
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Alahmad Maryam A, Omar Nadeen Mamon, Quraishi Mohammed Nabil
Аннотация
BACKGROUND: Subcutaneous (SC) infliximab offers pharmacokinetic and convenience advantages over intravenous (IV) therapy, but real-world data from the Middle East are lacking. This study evaluated SC infliximab outcomes in a prospective middle eastern inflammatory bowel disease (IBD) cohort.
METHODS: A prospective observational cohort study was conducted in the United Arab Emirates. Adult IBD patients were enrolled as switchers (transitioning from stable IV to SC infliximab 120 or 240 mg Q2W) or new starters (SC 120 mg Q2W following IV induction). Clinical outcomes and pharmacokinetics were assessed.
RESULTS: Fifty-eight patients were included (33 switchers [10 receiving 120 mg Q2W, 23 receiving 240 mg Q2W] and 25 new starters), with median follow-up of 10.1 months (interquartile range [IQR] 7.3-12.9). In the switcher cohort, 90.9% maintained clinical remission post-switch, with stable C-reactive protein (CRP), serum albumin, and fecal calprotectin, and significant increases in median trough concentrations: 9.5-20.0 mcg/mL in the 120 mg group (P = .044) and 8.0-42.0 mcg/mL in the 240 mg group (P = .001). Among new starters, 88% achieved clinical remission post-induction, with a median post-induction trough level of 16.0 mcg/mL; significant improvements in CRP, serum albumin, and fecal calprotectin were observed. Dose intensification was required in 28% of new starters. Drug persistence was high and comparable across all groups (log-rank P = .61), with 12-month rates of over 92% across all cohorts.
CONCLUSIONS: SC infliximab is effective for both switching and de novo IBD management in a middle eastern population, delivering high clinical remission rates, robust drug exposure, and durable treatment persistence.
METHODS: A prospective observational cohort study was conducted in the United Arab Emirates. Adult IBD patients were enrolled as switchers (transitioning from stable IV to SC infliximab 120 or 240 mg Q2W) or new starters (SC 120 mg Q2W following IV induction). Clinical outcomes and pharmacokinetics were assessed.
RESULTS: Fifty-eight patients were included (33 switchers [10 receiving 120 mg Q2W, 23 receiving 240 mg Q2W] and 25 new starters), with median follow-up of 10.1 months (interquartile range [IQR] 7.3-12.9). In the switcher cohort, 90.9% maintained clinical remission post-switch, with stable C-reactive protein (CRP), serum albumin, and fecal calprotectin, and significant increases in median trough concentrations: 9.5-20.0 mcg/mL in the 120 mg group (P = .044) and 8.0-42.0 mcg/mL in the 240 mg group (P = .001). Among new starters, 88% achieved clinical remission post-induction, with a median post-induction trough level of 16.0 mcg/mL; significant improvements in CRP, serum albumin, and fecal calprotectin were observed. Dose intensification was required in 28% of new starters. Drug persistence was high and comparable across all groups (log-rank P = .61), with 12-month rates of over 92% across all cohorts.
CONCLUSIONS: SC infliximab is effective for both switching and de novo IBD management in a middle eastern population, delivering high clinical remission rates, robust drug exposure, and durable treatment persistence.