For years, people living with moderate to severe IBD needed to access a foundational critical therapy at an infusion centre. Now they can have it at home.
About 1 in 140 Canadians is living with Crohn’s disease or ulcerative colitis — two of the most common forms of inflammatory bowel disease (IBD). While these are two different and distinct conditions, they share some common characteristics. Both involve inflammation of the lining of the gastrointestinal tract, and both can cause debilitating symptoms such as abdominal pain and cramping, diarrhea, rectal bleeding, weight loss, and poor appetite.
Since its approval over 20 years ago, a biosimilar known as infliximab has been a foundational therapy in treating moderate to severe IBD, as well as certain forms of rheumatoid arthritis (RA). However, until recently, the only way to receive this treatment was through intravenous injection administered at infusion centres — which, for some patients, can be inconvenient, time-consuming, and costly to access.
A new at-home option
With Health Canada’s recent approval of a subcutaneous form of infliximab, Canadians living with IBD now have the option to receive their treatment at home. This can help reduce the logistical challenges and costs of travelling to an infusion centre, which is especially meaningful to patients living in rural or remote areas away from major cities, where infusion centres are more common. With this new subcutaneous option, patients can self-inject their treatment at home and at their convenience based on a plan determined by their health care team.
Giving patients the choice as to where they prefer to receive treatment — at an infusion centre or at home — is a decisive step toward a new era of personalized medicine and a more patient-centric approach to managing IBD. Whether someone is new to this therapy or a long-time patient, this subcutaneous option offers many advantages to patients living busy lifestyles and managing family responsibilities. If subcutaneous infliximab is suitable, they may no longer have to arrange time off work to visit an infusion centre or worry about leaving their home, country, or care team for extended periods of time.
A wealth of efficacy and safety data
The approval of the subcutaneous administration of infliximab is the culmination of rigorous clinical trials and real-world data proving the efficacy and safety of this mode of treatment. This data was recently presented at the 19th Congress of European Crohn’s and Colitis Organisation. This level of robust data is not common with many biosimilars.
Whether it’s infusion or subcutaneous treatment, most biologic and biosimilar therapies offer extensive support programs to guide patients through their treatment journey, and this includes IBD patients. These programs often include tailored support and resources to meet their individual needs. Health Care Practitioners can offer more information about these offerings and their suitability for patients.
Depending on the specific therapy regimen, patients starting treatment may have to undergo a few infusion cycles before moving to the subcutaneous mode. Patients should speak to their physician and healthcare team who can recommend the best course of action based on their individual situation. The IV infusion of infliximab may be the most suitable option for patients who require greater attention from their care team or prefer not to self-inject their therapy. But either way, with this new mode of treatment delivery, patients with IBD now have more options and choice in managing their condition.
Q&A
Dr. Jason Reinglas
Gastroenterologist, Director of the Scarborough Centre for Inflammatory Bowel Disease
Dr. Jason Reinglas is a gastroenterologist, Director of the Scarborough Centre for Inflammatory Bowel Disease, clinical investigator at the Toronto Immune and Digestive Health Institute and associate at St. Michael’s Hospital. Mediaplanet recently talked to him about the challenges of living with inflammatory bowel disease (IBD) and how the new subcutaneous option of infliximab is helping reduce the disease burden.
What challenges do patients face in the diagnosis or treatment of IBD?
Sometimes the diagnosis is unclear and hard to come to terms with because it’s a lifelong illness without a medical cure. The treatments available alter the immune system to allow the bowel to heal itself enabling patients to live normal lives. Accepting the concept and time commitment that someone needs medication for the rest of their life can be challenging.
What can you tell us about the new Infliximab option?
Infliximab is one of our most effective and versatile agents for treating IBD. The main downfalls of it are that patients have to take four hours out of their day to get it at an infusion center frequently and their bodies can reject it, which may lead to dangerous infusion reactions. This new injectable version makes the medication more accessible to the patient and removes the risk of infusion reactions altogether.
What are some of the clinical advantages of the new subcutaneous infliximab option compared to traditional intravenous infusion?
Besides accessibility and no infusion reactions, the injectable version can achieve higher blood levels than the IV version. There is a strong relationship between how well this drug works and the blood level of it, so just by changing the delivery of it we can improve how well it can work.
How does this injectable option align with a more patient-centric approach to health care?
There are many medications available that treat IBD. Not all are effective for every type of IBD and not all suit the patient’s lifestyle. If the medication works but the patient won’t take it because it’s too inconvenient, then that medication is useless. Having an injectable option that allows patients more freedom is desirable for some. Some people like the idea of infusion centers, others like being in control of their care more and prefer injections. It’s important to have both IV and injectable options to cater to both groups of people.
To learn more about IBD treatment options, speak to your health care provider.
This article was sponsored by Celltrion Healthcare Canada, Ltd.
