P617 Switching from an intensified regimen of infliximab to a subcutaneous standard dose in adults with Inflammatory Bowel Disease: our experience in a tertiary hospital.
Chivato Martín Falquina , I.(1);Saiz Chumillas , R.M.(1);Arias Garcia , L.(1);Vicente González , B.(2);Revilla Cuesta , N.(2);Alba Hernández , L.(1);Andrés Pascual , L.(1);Sicilia Aladrén , B.(1);
(1)Hospital Universitario de Burgos, IBD unit- gastroenterology, Burgos, Spain;(2)Hospital Universitario de Burgos, Hospital Pharmacy, Burgos, Spain;
Intravenous (IV) infliximab is a first line treatment for moderate or severe flare of inflammatory bowel disease. Recently a new formulation of infliximab with subcutaneous (SC) administration has been developed and approved for this indication.
Four patients (28,57%) were diagnosed with CD, 10(71,4%) were diagnosed with UC (Table 1). Median duration of IV treatment was 53 months (IQR 33-59). Reasons for starting infliximab were corticodependence in 6 patients (42,8%), corticorefractoriness in 6(42,8%) and topdown strategy in B2 phenotipe with Crohn’s disease in 2 (14,3%). Reasons for intensification were: loss of response in 5 patients (35,7%), intensified induction in one (7,1%), proactive therapeutic drug monitoring in 8 (57,14%) (graphic 1). Intensification regimens are shown in graphic 2. Eleven patients (78,57%) were still in an intensified regimen when switched. All patients were in clinical and biochemical remission (FC<200 µg/g and CRP<10 mg/dl) before switch. Median basal infliximab trough levels before switch were 6,98µg/ml (IQR 2,4-10,5); median trough levels 8 weeks after switch were 14,12 (IQR 12,22-22,7) (p=0,003) (graphic 3). Thirteen patients (92,8%) followed treatment and stayed in clinical remission. One patient, treated with original IV infliximab before switch, relapsed after third subcutaneous administration, and did not respond to reintroduction of original IV infliximab. There were no adverse events.