S1601 Effectiveness of Switching From Intravenous to Subcutaneous Infliximab in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction: Intravenous (IV) infliximab is widely used in managing inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Recently, subcutaneous (SC) infliximab has gained attention as a maintenance strategy, offering improved patient convenience, enhanced pharmacokinetics, and reduced healthcare burden. With growing real-world and trial-based evidence, a comprehensive synthesis is needed to guide therapeutic decisions. This study systematically reviews outcomes following the switch from IV to SC infliximab in IBD patients. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines to evaluate 12-month clinical and biochemical remission, as well as treatment discontinuation rates, after switching from IV to SC infliximab in ulcerative colitis and Crohn’s disease. Eight eligible studies were identified through PubMed, Scopus, and Google Scholar searches up to April 2025. These studies were conducted across multiple nations. Two reviewers independently extracted data and assessed study quality using the Newcastle–Ottawa Scale. Pooled estimates were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and leave-one-out sensitivity analyses were performed to test robustness. Results: Across the 8 studies comprising 1,076 patients, Crohn’s disease was the predominant subtype in most cohorts, with males representing a greater proportion of participants in several studies. Twelve-month clinical remission was achieved in 80.8% of patients (95% CI: 77.2–84.4), with moderate heterogeneity (I² = 42.26%), suggesting consistent benefit across studies. Biochemical remission was observed in 61.3% (95% CI: 55.1–67.5), also with moderate heterogeneity (I² = 49.29). The overall discontinuation rate was low at 7.2% (95% CI: 3.6–10.7), though substantial heterogeneity was noted (I² = 83.5), indicating variability in treatment persistence or tolerability. Conclusion: These results support the effectiveness and feasibility of switching to subcutaneous infliximab in maintaining remission over one year, with acceptable discontinuation rates. More uniform study designs may help clarify the determinants of treatment discontinuation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.048 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".