Authors: Stefan Schreiber, Shomron Ben-Horin, Rieke Alten, René Westhovens, Laurent Peyrin-Biroulet, Silvio Danese, Toshifumi Hibi, Ken Takeuchi, Fernando Magro, Yoorim An, Dong-Hyeon Kim, SangWook Yoon & Walter Reinisch
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has prompted significant changes in patient care in rheumatology and gastroenterology, with clinical guidance issued to manage ongoing therapy while minimising the risk of nosocomial infection for patients and healthcare professionals (HCPs). Subcutaneous (SC) formulations of biologics enable patients to self-administer treatments at home; however, switching between agents may be undesirable. CT-P13 SC is the first SC formulation of infliximab that received regulatory approval and may be termed a biobetter as it offers significant clinical advantages over intravenous (IV) infliximab, including improved pharmacokinetics and a convenient mode of delivery. Potential benefits in terms of reduced immunogenicity have also been suggested. With a new SC formulation, infliximab provides an additional option for dual formulation, which enables patients to transition from IV to SC administration route without changing agent. Before COVID-19, clinical trials supported the efficacy and safety of switching from IV to SC infliximab for patients with rheumatoid arthritis and inflammatory bowel disease (IBD), and SC infliximab may have been selected on the basis of patient and HCP preferences for SC agents. During the pandemic, patients with rheumatic diseases and IBD have successfully switched from IV to SC infliximab, with some clinical benefits and high levels of patient satisfaction. As patients switched to SC therapeutics, the reduction in resource requirements for IV infusion services may have been particularly welcome given the pandemic, facilitating reorganisation and redeployment in overstretched healthcare systems, alongside pharmacoeconomic benefits and a reduction in exposure to nosocomial infection. Telemedicine and contactless healthcare have been pushed to the forefront during the pandemic, and a lasting shift towards remote patient management and community/home-based drug administration is anticipated. SC infliximab supports the implementation of this paradigm for future improvements of healthcare value delivered. The accumulation of real-world data during the pandemic supports the high level of confidence, with patients, physicians, and healthcare systems benefitting from its uptake.
Graphical abstract
The authors, CC-BY-NC 2021.
Key Summary Points |
The coronavirus disease 2019 (COVID-19) pandemic has caused a significant burden on healthcare services, including chronic inflammatory diseases such as rheumatic diseases and inflammatory bowel disease (IBD) |
The first subcutaneous (SC) formulation of infliximab, CT-P13 SC, offers several advantages over its intravenous (IV) formulation, in terms of an improved pharmacokinetic profile and convenient administration method |
Recognition of these ‘biobetter’ qualities of SC infliximab were growing among physicians and patients prior to the COVID-19 pandemic, tipping their preferences in favour of the SC formulation |
Real-world data from patients successfully switching from IV to SC infliximab in rheumatic diseases and IBD settings during the pandemic have supported the clinical findings from the pivotal studies and demonstrated the benefits of SC infliximab for patients, as well as healthcare systems from resource allocation and pharmacoeconomic perspectives |
The pandemic has pushed telemedicine and contactless healthcare to the forefront; self-administered biologics like SC infliximab are an important element of remote management of patients with rheumatic diseases and IBD, with SC infliximab expected to remain a cornerstone therapy in the telemedicine concepts beyond the pandemic era |