Intravenous versus subcutaneous delivery of biotherapeutics in IBD: an expert’s and patient’s perspective

Abstract

Several biologic treatments are available in addition to intravenous also in subcutaneous form for treatment of chronic diseases. Benefits of the subcutaneous application of drugs include self-administration by the patient, shorter time of application process with less infusion related adverse events and consequently lower healthcare costs. With appropriate education and support patients are able to administer their treatments at home. This leads to improvement of quality of life, reduction of time needed to travel to the healthcare institution and consequently also reduces costs also for the patient.Over one million residents in the USA and 2.5 million in Europe are estimated to have inflammatory bowel disease (IBD), with substantial costs for health care. These estimates do not factor in the ‘real’ price of IBD, which can impede career aspirations, instil social stigma and impair quality of life in patients.The Virtual Community Meeting, which offered an exchange of experience and opinions from healthcare professionals who are active in treating IBD, and patients with this chronic disease, revealed in-depth arguments and answers to some essential questions: which patients prefer subcutaneous over intravenous dosing; which patients continue to favour intravenous infusions; what are the limitations regarding both applications; what is the patient’s role in therapeutical decision-making and how does IBD affect the patient’s work, finances and quality of life? The aim of this article is to discuss the differences between subcutaneous and intravenous dosing from the health-economic, scientific, and personal perspectives.The meeting offered strong confirmation that most of the patients and healthcare professionals prefer subcutaneous over intravenous drug administration but emphasise the management of risks associated with treatment compliance. Patient education provided by the IBD team in this regard is mandatory. Quality of life of patients is poorer during active disease, but the findings that it can improve over time, including as a result of home- or self-administration of biologics, may be encouraging for individuals with this chronic disease.

Trends in industrialization of biotherapeutics: a survey of product characteristics of 89 antibody-based biotherapeutics

“…This less frequent dosing regimen is clearly advantageous from the perspective of patient convenience (Table S1). 134 However, even with such advantages, the patients and clinicians may not always prefer s.c . over i.v .…”

Carbon-Based Nanomaterials as Drug Delivery Agents for Colorectal Cancer: Clinical Preface to Colorectal Cancer Citing Their Markers and Existing Theranostic Approaches

“…The oral route is noninvasive and easy for intake of the drugs. The intratumoral route is highly effective for tumor targeting precisely into the tumor environment, thereby preventing nonspecific adverse effects. − Biopersistence and biodistribution are other key factors to be considered for the safe use of CNTs as functionalization can improve the biocompatibility and biodegradation of CNTs. , …”

Real-World Study on Vedolizumab Serum Concentration, Efficacy, and Safety after the Transition from Intravenous to Subcutaneous Vedolizumab in Inflammatory Bowel Disease Patients: Single-Center Experience

“…As well, there is a possibility of an inappropriate storage of the drug at home, which can lead to lower effectiveness or adverse events. Some patients, moreover, dislike the idea of self-injecting or more frequent dosing of subcutaneous formulations [ 15 ]. In recent studies on patient acceptance of switching from intravenous infliximab or vedolizumab to subcutaneous formulations of the drug, the majority (58–78%) of the patients accepted the switch, and the main motivation was saving time [ 16 , 17 ].…”