SUBCUTANEOUS INFLIXIMAB IN REFRACTORY CROHN'S DISEASE PATIENTS AFTER THE MULTIPLE TREATMENT FAILURES - SHORT TREATMENT OUTCOMES

Abstract BACKGROUND Subcutaneous administration of infliximab shows an increased benefit in terms pharmacokinetics and pharmacodynamics effects compared to the intravenous infliximab. The practical question arises whether routine refractory CD patients who have failed prior biological therapy will provide "biobetter" clinical efficacy. AIMS We propose a single center study designed evaluate SC-IFX treatment outcomes with active after previous failures other biologicals (TMAbs). Such cohort was chosen because there is currently insufficient appropriate medication available for these identification parameters predicting response could be great some them. PATIENTS & METHODS A total 32 were included, median age 34.5 years duration 11 years; >90% them stricturing and/or penetrating disease behavior, >80% ileocolic involvement, about 40% perianal disease. Eighteen (56%) on ≥3 TMAbs, rest 2 TMAbs. Twenty (62.5%) n = had IV-IFX past; this sub-cohort, 85% positive anti-IFX antibodies (ATI). In ATI-positive induction realized four 120 mg SC doses weekly. Two IV infusions 5 mg/kg IFX administered 2-week intervals ATI-negative sub-cohort. Maintenance whole consisted bi-weekly. RESULTS Of patients, 7 individuals during phase: one heart progression, 6 due delayed hypersensitivity reactions systemic manifestation. 25/32 continued their up W14, initial Harvey-Bradshaw index (HBI) (min 1, max 28) did not decrease significantly within 14 weeks (p=0.067). However, both serum CRP level (p=0.039) fecal calprotectin (p=0.027) shown significant decrease. Median trough levels from μg/mL at W2 10 W14 (p<0.001), ATI dropped 38 ng/mL (p= 0.0004). None zero new formation. Moreover, 17 (59%) positivity, decreased even cut-off levels. only risk factor discontinuation before high ATIs (p < 0.001). CONCLUSIONS Our short-term experience efficacy tolerability complicated multiple TMAbs failures.The research gap information biobetters IBD must filled predictive factors found.