What factors do you consider when a patient with acute severe ulcerative colitis flare responds to inpatient Infliximab, and you are deciding whether to switch to subcutaneous or continue IV maintenance dosing of Infliximab?

Patients admitted with acute severe ulcerative colitis typically have higher drug clearance related to significant fecal loss of infliximab through a highly inflamed colon, leading to low levels and often the need for dose escalation. There have been studies showing that infliximab levels in severe UC patients are about half of what they are in patients who are in remission. As such, I tend to keep these patients on IV infliximab after discharge, given that the frequency and/or dose of inflixima...

Many Patients with ASUC require higher IV dosing or shorter intervals, at least until remitted. If they require more than standard maintenance dosing, it might be difficult to get approval for WEEKLY subcutaneous dosing (approved in Europe), so I am hesitant to switch until the option of higher subcutaneous dosing becomes available.

My conflict is that I have written many articles on subcutaneous dosing with Celltrion.