Cure8 research brief
This study addresses a common problem in Crohn's patients on infliximab: low drug levels despite IV dosing. It suggests switching to a subcutaneous infliximab formulation can raise and stabilize trough concentrations compared with doubling the IV dose, which may matter when trying to optimize therapy.
Adults with Crohn's disease receiving infliximab who have low trough levels, clinicians who manage biologic dosing and therapeutic drug monitoring, and researchers studying biologic delivery methods.
This prospective comparative cohort study of young adults with Crohn's disease compared switching to subcutaneous (SC) infliximab versus continuing intravenous (IV) infliximab at a doubled dose for patients with low trough levels (<3 µg/mL).
Over 52 weeks the SC group had substantially higher infliximab trough levels at weeks 24 and 52 and met predefined trough thresholds more often; rates of mucosal healing at week 52 were similar between groups.
The article reports pharmacokinetic advantages for SC infliximab in this cohort, but it did not find a statistically significant difference in mucosal healing. The findings are from an exploratory, non-randomized cohort in young adults who chose the strategy, which can introduce selection bias.
If you are managing infliximab underexposure, this study suggests SC infliximab can produce higher and more stable drug levels compared with doubling IV dose, but clinical outcomes (mucosal healing) were not different in this report. Decisions about dose optimization should still be individualized and discussed with your clinician.
Structured content depth: abstract. The report is a prospective, non-randomized cohort where patients selected the strategy; that can introduce selection bias. The study focused on young adults and used pharmacokinetic endpoints (trough levels) plus endoscopic mucosal healing at 52 weeks.
Full peer-reviewed article details and larger randomized trials would provide stronger evidence.
Review the original publication for the complete reporting, methods, and context.
Conflict statement: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mi Jin Kim reports financial support was provided by Celltrion, Inc. Mi Jin Kim reports a relationship with Celltrion, Inc. that includes: funding grants and speaking and lecture fees. Mi Jin Kim reports a relationship with Samsung Bioepis.Co., Ltd. that includes: funding grants and speaking and lecture fees. Mi Jin Kim reports a relationship with Takeda Pharmaceutical Company Limited that includes: funding grants and speaking and lecture fees. Mi Jin Kim reports a relationship with Johnson & Johnson Innovative Medicine that includes: funding grants and speaking and lecture fees. Mi Jin Kim reports a relationship with AbbVie Inc that includes: funding grants and speaking and lecture fees. Mi Jin Kim reports a relationship with Eli Lilly and Company that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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