Subcutaneous
infliximab recently received approval for the treatment of various immune-mediated inflammatory diseases in Europe, following pivotal clinical trials in patients with
rheumatoid arthritis and
inflammatory bowel disease. Subcutaneous
infliximab demonstrated an improved pharmacokinetic profile compared with intravenous
infliximab: the more stable exposure and increased systemic drug concentrations mean it has been cited as a biobetter. Alongside the pharmacokinetic advantages, potential benefits for efficacy, immunogenicity, and health-related quality-of-life outcomes have been suggested with subcutaneous
infliximab. During the
coronavirus disease 2019 pandemic, the benefits of subcutaneous over intravenous
therapies became apparent: switching from intravenous to subcutaneous
infliximab reduced the hospital visit-related healthcare resource burden and potential viral transmission. Clinical advantages observed in pivotal trials are also being seen in the real world. Accumulating experience from four European countries (the UK, Spain, France, and Germany) in patients with
rheumatic diseases and
inflammatory bowel disease supports clinical trial findings that subcutaneous
infliximab is well tolerated, increases serum drug concentrations, and offers maintained or improved efficacy outcomes for patients switching from intravenous
infliximab. Initial evidence is emerging with subcutaneous
infliximab treatment after intravenous
infliximab failure. High patient satisfaction and pharmacoeconomic benefits have also been reported with subcutaneous
infliximab. Treatments aligned with patient preferences for the flexibility and convenience of at-home subcutaneous administration could boost adherence and treatment outcomes. Altogether, findings suggest that switching from intravenous to subcutaneous
infliximab could be advantageous, and healthcare professionals should be prepared to discuss supporting data as part of shared decision making during patient consultations.