Restarting infliximab after a break? Go subcutaneous. A post-hoc analysis of the LIBERTY-CD and LIBERTY-UC trials found that subcutaneous infliximab (Zymfentra) successfully recaptured clinical response in IBD patients after a drug holiday — and antidrug antibodies didn't get in the way. Drug concentrations rose over time regardless of antibody status, suggesting a more effective re-entry route than the traditional IV approach.
Restarting infliximab after a break? Go subcutaneous.
For patients with inflammatory bowel disease (IBD) who need to pause treatment — a so-called "drug holiday" — reintroducing IV infliximab has long been tricky due to the risk of antidrug antibodies (ADAs) undermining its effectiveness. But new data presented at the ACG Annual Scientific Meeting suggest subcutaneous infliximab (Zymfentra) may sidestep that problem entirely.
A post-hoc analysis of the LIBERTY-CD and LIBERTY-UC trials showed that patients who initiated subcutaneous infliximab 240 mg after a drug holiday achieved strong clinical response and remission rates — and those outcomes held up whether or not patients had pre-existing ADAs. Serum infliximab levels rose over time in both ADA-positive and ADA-negative patients, and the proportion of ADA-positive individuals actually declined after subcutaneous initiation.
Key Takeaways:
Why it matters: Many IBD patients cycle through multiple therapies but feel best on infliximab. Subcutaneous delivery may now offer a more immunologically forgiving — and clinically effective — path back to a drug that works for them.
