Subcutaneous vs Intravenous Infliximab Shows Improved Efficacy in Patients With RA

Compared with intravenous infliximab, subcutaneous infliximab showed improvements in efficacy in patients with RA.

Subcutaneous vs intravenous infliximab was found to have improved efficacy after 30 weeks, according to study results published in Annals of the Rheumatic Diseases.

In a post hoc analysis of a phase 3 study (ClinicalTrials.gov Identifier: NCT03147248), researchers compared the efficacy of subcutaneous vs intravenous infliximab in the treatment of RA and whether numerical differences in efficacy outcomes at weeks 30 and 54 were statistically significant.

Eligible patients had active RA (defined as ≥6 tender joints, ≥6 swollen joints, and a serum C-reactive protein [CRP] concentration of >0.6 mg/dL) for 30 or more weeks and an inadequate response to 3 or more months of methotrexate (MTX) treatment. Patients received 3 mg/kg of intravenous infliximab at week 0 and 2 and were randomly assigned 1:1 to receive subcutaneous infliximab every 2 weeks or intravenous infliximab every 8 weeks thereafter. Participants in the intravenous group were switched to the subcutaneous group from weeks 30 through 54.

In the post hoc analysis, researchers compared efficacy outcomes both pre- (at week 30) and postswitch (at week 54), using last observation carried forward and conservative nonresponder imputation to identify differences in disease activity.

The positive efficacy outcomes following switching from IFX i.v. to IFX s.c. should provide reassurance for stakeholders, including healthcare professionals and patients considering this treatment switch.

A total of 343 patients were included in the analysis (165 in the subcutaneous group and 174 in the intravenous group).

Researchers noted that subcutaneous vs intravenous infliximab was associated with significantly greater improvements in clinical efficacy outcomes, including 28-joint Disease Activity Score (DAS28)-CRP, DAS28 erythrocyte sedimentation rate (ESR), Clinical Disease Activity Index (CDAI), and Simplified Disease Activity Index (SDAI), and minimally clinically important differences in health assessment questionnaire (HAQ) score.

At the 30-week switch from intravenous to subcutaneous infliximab, fewer between-group differences in efficacy were observed at week 54.

Researchers concluded, “The positive efficacy outcomes following switching from [infliximab intravenous] to [infliximab subcutaneous] should provide reassurance for stakeholders, including healthcare professionals and patients considering this treatment switch.”

Disclosure: This research was supported by Celltrion Healthcare Co Ltd. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References:

Constantin A, Caporali R, Edwards CJ, et al. Efficacy of subcutaneous vs intravenous infliximab in rheumatoid arthritis: a post-hoc analysis of a randomised phase III trial. Rheumatology (Oxford). Published online December 19, 2022. doi:10.1136/annrheumdis-2022-eular.2225