Wils Pauline, Fumery Mathurin, Nachury Maria, Yzet Clara, Coban Dilek, Buisson Anthony
Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille, Lille, France.
Univ. Lille, Inserm, CHU Lille, U1286-INFINITE-Institute for Translational Research in Inflammation, Lille, Hauts-de-France, France.
Therap Adv Gastroenterol. 2025 Mar 22;18:17562848251326471. doi: 10.1177/17562848251326471. eCollection 2025.
We assessed the evolution of perianal lesions after switching intravenous (IV) to subcutaneous (SC) infliximab in patients with Crohn's disease (CD).
Subgroup analysis of REMSWITCH studies.
We described the clinical and MRI outcomes of patients with a prior or current CD perianal lesions after the switch.
In REMSWITCH, 40 CD patients had a prior history of perianal lesions. No patient experienced a new perianal lesion (median follow-up = 18 months). Among the three patients (3/40, 7.5%) with clinically active perianal lesions at baseline, two patients had no more perianal lesions at month 18 while the last patient experienced lesions worsening. Another one with active perianal lesions on MRI but no symptom at baseline did not have any relapse within 18 months. Only one patient (1/40, 2.5%) had a perianal relapse (at month 25) with remission recapture after SC infliximab intensification.
Switching from IV to SC infliximab in CD with perianal lesions is safe and feasible.
我们评估了克罗恩病（CD）患者静脉注射（IV）英夫利昔单抗转换为皮下注射（SC）英夫利昔单抗后肛周病变的演变情况。
REMSWITCH研究的亚组分析。
我们描述了转换后有既往或当前CD肛周病变患者的临床和MRI结果。
在REMSWITCH研究中，40例CD患者有肛周病变病史。无患者出现新的肛周病变（中位随访时间 = 18个月）。在基线时有临床活动性肛周病变的3例患者（3/40，7.5%）中，2例患者在第18个月时不再有肛周病变，而最后1例患者病变恶化。另1例患者MRI显示有活动性肛周病变但基线时无症状，在18个月内未出现任何复发。仅1例患者（1/40，2.5%）出现肛周复发（在第25个月），在强化皮下注射英夫利昔单抗后缓解得以恢复。
对于有肛周病变的CD患者，从静脉注射英夫利昔单抗转换为皮下注射英夫利昔单抗是安全可行的。
