P0056 Efficacy of Infliximab in Biologic-Experienced Patients with Inflammatory Bowel Disease: A Retrospective Study
Authors: Borges Chaves C , Corveira J , Ferreira A M , Lopes S , Mendes S , Ferreira M , Narra Figueiredo P , Portela F 
Published: January 2025

Background

Infliximab is typically the first biologic choice for patients with inflammatory bowel disease (IBD), and its role is well-established in biologic-naive patients. However, based on patient characteristics, an alternative biologic may sometimes be selected as the initial treatment, with numerous options currently available. In cases of intolerance or loss of response to these alternatives, the role of Infliximab in biologic-experienced patients remains unclear1,2.

This study aims to evaluate the efficacy of Infliximab in a cohort of biologic-experienced patients.

Methods

We conducted a retrospective study at a tertiary centre, including all biologic-experienced patients with IBD who were subsequently treated with Infliximab. Clinical records were thoroughly reviewed to collect data on demographics, prior and current medication, and clinical, endoscopic, analytical and histological disease activity. Statistical analysis was performed using SPSS Statistics version 26®.

Results

Seventeen patients were included, of whom 6 females, with a mean age of 45.8 ± 17.6 years. Twelve patients with ulcerative colitis (UC) and five with Crohn’s disease (CD) were identified. Of the 17 patients, 10 had previously been treated with an anti-TNFα agent (either Adalimumab or Golimumab), 4 with Vedolizumab, 1 with Guselkumab and 2 with an anti-TNFα (both Adalimumab) followed by other drugs with distinct mechanism of action (Vedolizumab alone in 1, Ustekinumab and Tofacitinib in the other). All these drugs were suspended due to primary failure (PF), except for two (both Adalimumab) due to secondary failure (SF). Currently, 8 patients are continuing treatment with Infliximab, of which 5 are UC patients, all in clinical remission and 1 in deep remission; and 3 CD patients, all in clinical remission with a current Harvey-Bradshaw score of 1. Of those who discontinued Infliximab (9 patients), 4 were due to PF, 3 due to SF, 1 due to death (not related with disease or drug administration) and the other due to treatment refusal.

Conclusion

Infliximab appears to be effective in certain biologic-experienced IBD patients and given its lower cost this treatment option may be viable. Nonetheless, larger series are needed for a more comprehensive understanding, to allow an inferential statistical analysis and define the best candidates to Infliximab.

References

1. Grillo, S., Mezzina, N., Landi, S., Massari, A., Grassi, E., Dell’Era, A., & Ardizzone, S. (2018). P.07.22 Anti-TNF-Alfa Second-Line Infliximab Therapy in Patients Affected by Crohn’s Disease and Ulcerative Colitis: Who and How Recovers Remission? Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology (SIGE) and of the Italian Association for the Study of the Liver (AISF), 50(2).

2. Russo E, Hackett R, Campbell S, et alPWE-071 Efficacy Of Infliximab As Second-line Biologic In Crohn’s DiseaseGut 2014;63:A154-A155.