SWITCHING FROM INTRAVENOUS TO SUBCUTANEOUS INFLIXIMAB IN PATIENTS WITH IMMUNE MEDIATED DISEASES IN CLINICAL REMISSION

Nikolaos Viazis^1*Anastasios Karamanakos¹Konstantinos Mousourakis¹Angeliki Christidou¹Fotios Fousekis²Konstantinos Mpakogiannis²Anastasios Koukoudis²Kostas Katsanos²Dimitrios Christodoulou²Myrto Cheila¹MARIA TZOUVALA³EIRINI ZACHAROPOULOU³Maria Palatianou³Olga Giouleme⁴ANASTASIA KATSOULA⁴Christos Liatsos⁵Nikos Kyriakos⁵Evi Zampeli⁶Evgenia Papathanasiou⁶Angeliki Theodoropoulou⁷Konstantinos Karmiris⁷Ioannis Psaroudakis⁷George Tribonias⁸Souzanna Gazi⁹Evangelia Mole⁹Theodoros Dimitroulas¹⁰Christos Koutsianas¹¹Dimitrios Vassilopoulos¹¹George E Fragoulis¹²Nikos Michalakeas¹²Charalampos Papagoras¹³Pantelis Panagakis¹⁴Marina Papoutsaki¹⁴Vasiliki Chasapi¹⁴Alexandros Stratigos¹⁴George Katsikas¹

• ¹Evaggelismos General Hospital, Athens, Greece
• ²University Hospital of Ioannina, Ioannina, Greece
• ³General Hospital Nice Piraeus Saint Panteleimon, Piraeus, Greece
• ⁴Second propeudetic department of internal medicine, Hippokration General Hospital Thessaloniki, Thessaloniki, Greece
• ⁵401 General Military Hospital of Athens, Athens, Greece
• ⁶Alexandra General Hospital, Athens, Greece
• ⁷The General Hospital of Heraklion 'Venizeleio-Pananio', Heraklion, Greece
• ⁸Erythros Stavros, Athens, Greece
• ⁹KAT Hospital, Athens, Greece
• ¹⁰General Hospital Ippokrateio Thessaloniki, Thessaloniki, Greece
• ¹¹Ippokrateio General Hospital Athens, Athens, Greece
• ¹²Laiko General Hospital of Athens, Athens, Greece
• ¹³University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, Greece
• ¹⁴Andreas Sygros Hospital, Athens, Greece

Aim: To report on the efficacy and safety of elective switching from intravenously (IV) to subcutaneously (SC) administered Infliximab (IFX) in patients with immune mediated diseases.Methods: Retrospective analysis of patients with Crohn's disease (CD), Ulcerative Colitis (UC), Spondyloarthritis (SpA), Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and chronic plaque Psoriasis (PsO) who were receiving IFX-IV for maintenance of remission in tertiary referral centers and were switched to IFX-SC based on their physician's choice. All patients with gastrointestinal and skin diseases were in clinical remission, while those with musculoskeletal disease had inactive disease or low disease activity. The primary endpoint was disease deterioration during the a follow up period, of at least 6 months, according to disease specific composite measures.Results: Between April 2023 and April 2024, a total of 344 patients (CD=136, UC=62, SpA=52, PsA=38, RA=7, PsO=44, co-existence of more than one disease=5) were switched from IFX-IV to IFX-SC. After a mean± (SD) follow up period of 8±4 (4) months, 12 patients (3.5%) discontinued treatment with IFX-SC. Five of them (1.5%) because of disease worsening and the remaining 7 (2.0%) because of the occurrence of side effects. All other 332332 other patients (96.5%) showed favorable response, none of them requested an unscheduled visit, or developed an adverse event (clinical or laboratory) or needed escalation of treatment.Elective switching from IFX-IV to IFX-SC seems to be an effective and safe approach in real-world every day clinical practice to maintain long-term clinical remission, inactive disease or low disease activity in patients with immune-mediated diseases.