Amy Stewart, NP, on Advances in Subcutaneous IBD Therapy

Amy Stewart, NP, reviews the results of a post-hoc analysis of data from the LIBERTY study in Crohn's disease for Zymfentra, a subcutaneous formulation of infliximab, and how it and other subcutaneous options provide important options for patients with IBD.

Amy Stewart, MSN, FNP-C is the lead Advanced Practice Provider for her division of Capital Digestive Care in Washington, DC.

TRANSCRIPT:

Hi, I am Amy Stewart, nurse practitioner at Capital Digestive Care in Washington DC. I'm thrilled to be here at the Advances in Inflammatory Bowel Disease annual conference 2025.

Let's talk about the real changing landscape in IBD. Over the past couple of years, our landscape has exploded, quite frankly. We have so many more options than we've ever had in the past for our patients with Crohn's disease and ulcerative colitis, and with that shared decision making for our patients is truly essential. In order to do shared decision making, we have to have conversations with our patients and understanding what their true preferences are.

Historically, many of us have thought that we really needed the IV medications in order to get our patients really into remission, but the subcutaneous injections that have been approved in the last number of years have really changed that thought process. We now have lots of options for our patients.

In many classes with sub-q injections, patients being able to self-inject their medications at home really increases access for all of our patients. With IBD want to talk specifically about Zymfentra, which is a subcutaneous formulation of infliximab. Zymfentra was approved in the last couple of years and is approved for the maintenance of both Crohn's disease and ulcerative colitis. And I think historically, again, many of us have thought that we really needed IV medication, but Zymfentra's clinical data is really changing that view.

When we talk to our patients about options, if they want IV infusions or injections, we can do a couple of things. One is talk to them about their schedules, right? Do they have access to an infusion center? Are they in an area where there's even infusion center near them within an hour or two drive? Or do they have a work schedule where they can get to an infusion center? I, for example, have a job where it's not really easy to leave in the middle of the day and go get an infusion. But sub-q options have really expanded our portfolio for patients with Zymfentra. They also have new data this year, so it was just a press release of post-hoc analysis of the LIBERTY data in Crohn's disease. So overall, about just under half of patients had ileal predominant Crohn's disease. In this study and in the post-hoc analysis, almost 61% of patients achieve clinical remission at one year on Zymfentra, of whom had ileal predominant Crohn's disease. When we think about our historically hard to treat patients, which is ileal predominant Crohn's disease, we now really have reassuring data that a subcutaneous option of infliximab like Zymfentra can work for those patients.

Te other historical thought is that maybe patients on sub-q formulations don't have high trough levels in order to get enough therapeutic level. But actually Zymfentra’s data counters that argument, too, and in their PK data trough levels on subcutaneous formulation of infliximab were actually higher than their IV counterparts. This gives us a lot of reassurance that Zymfentra is a great option for our patients for subcutaneous infliximab with both Crohn's disease and ulcerative colitis.

So to recap again, the landscape of inflammatory bowel disease has really changed in the last couple of years, and subcutaneous options like Zymfentra infliximab for maintenance for our patients is a great option for those with Crohn's disease or ulcerative colitis who have moderately to severe disease. Thank you again. Amy Stewart, nurse practitioner at Capital Digestive Care, thrilled to be here at the AIBD 2025 National Conference.