Subcutaneous Infliximab Effective Across Ileal and Colonic Crohn’s Disease
Subcutaneous infliximab (IFX SC) demonstrated consistent efficacy across disease locations in patients with moderately to severely active Crohn’s disease (CD), including the terminal ileum, according to a subgroup analysis of the phase 3 LIBERTY-CD trial. The findings address a longstanding challenge in treating ileal disease, which is often considered more refractory to therapy.
The analysis included 329 patients who responded to intravenous infliximab induction and were randomized to IFX SC 120 mg every 2 weeks or placebo for maintenance therapy. Patients were stratified by baseline disease location as ileum-dominant or colon-dominant, with outcomes assessed through week 54.
At one year, IFX SC significantly improved clinical and endoscopic outcomes compared with placebo in both ileal and colonic disease. Treatment effects were similar regardless of disease location, despite the known difficulty in achieving response in ileal involvement.
The authors reported that “IFX SC significantly improved all efficacy endpoints vs placebo,” and emphasized that efficacy was maintained “regardless of disease location.” Segmental analysis further demonstrated that “endoscopic responses…were greater with IFX SC vs placebo across all ileocolonic segments, including the terminal ileum.”
Serum drug exposure appeared to influence outcomes. Higher infliximab levels at weeks 14 and 54 were associated with both clinical remission and endoscopic response across disease locations, suggesting a pharmacokinetic component to sustained efficacy.
Reference
Sands BE, Schreiber S, Dubinsky MC, et al. Endoscopic response to subcutaneous infliximab by disease location: a post hoc analysis of the LIBERTY-CD study. Clin Gastroenterol Hepatol. 2026;24(4):1111-1120. doi:10.1016/j.cgh.2025.11.017
