This medication review explores the role of stable pharmacokinetics (PK) in achieving continuous inflammatory control in inflammatory bowel disease (IBD), with a focus on subcutaneous infliximab therapy for Crohn’s disease and ulcerative colitis. Kim Orleck, PA-C, from Atlanta Gastroenterology Associates and United Digestive, reviews how subcutaneous infliximab provides more stable and sustained drug exposure compared with traditional intravenous (IV) infliximab dosing. By minimizing peak-to-trough fluctuations and maintaining higher trough concentrations, subcutaneous infliximab may help support continuous TNF inhibition, reduce immunogenicity risk, and improve long-term disease control in patients with moderate to severe IBD.

The discussion highlights key clinical data from studies including REMSWITCH, LIBERTY Crohn’s, and LIBERTY UC, demonstrating that subcutaneous infliximab delivers durable remission, stable safety outcomes, and consistent therapeutic drug levels through long-term follow-up. Learn how transitioning from IV to subcutaneous infliximab may improve patient convenience, maintain clinical and endoscopic remission, and support treat-to-target goals in IBD management. The review also examines which patients may require closer monitoring or dose escalation strategies following the switch from IV biologic therapy. For more educational content visit the GHAPP Digital Hub and the GHAPP ACE app.

Thank you to J&J for the support of this Journal Club Review Module. In this journal club video, Sharon Dudley Brown, CRNP, PhD, from the IBD Center at Johns Hopkins University, reviews the ASTRO trial published in The Lancet, which evaluated subcutaneous guselkumab for the treatment of moderate to severe ulcerative colitis. The discussion highlights how this IL-23 inhibitor was studied in patients with difficult-to-treat disease who had previously failed or were intolerant to standard therapies. The trial compared different dosing strategies of subcutaneous guselkumab versus placebo and assessed clinical remission, symptom improvement, and endoscopic outcomes over time.

Results showed that patients receiving guselkumab had higher rates of remission and improved colon inflammation compared with placebo, with benefits seen early in treatment and sustained through follow-up. Safety outcomes were generally similar between groups, with no new safety concerns identified. Overall, the ASTRO trial supports subcutaneous guselkumab as an effective and well-tolerated option for patients with moderate to severe ulcerative colitis.

Thank you to AbbVie for the support of this Journal Club Review Module. This journal club review episode explores the benefit–risk profile of Upadacitinib for patients with moderately to severely active Ulcerative Colitis and Crohn’s Disease, based on a post hoc analysis of phase 2b/3 clinical trials. Featuring expert insights from Sally Bowa, APNP, FNP-C and Jennifer Labas, MSN, in both community and academic settings, this discussion breaks down real-world considerations including efficacy, safety outcomes, and long-term disease management. Key topics include rapid symptom relief, induction and maintenance of remission, and how upadacitinib compares to other advanced therapies in IBD treatment sequencing. The episode also highlights important safety considerations such as herpes zoster risk, cardiovascular events, and thrombosis, along with practical strategies like vaccination protocols, lab monitoring, and patient selection. Designed for gastroenterology and hepatology advanced practice providers, this episode provides actionable guidance on balancing risks and benefits, optimizing treatment decisions, and improving patient outcomes in complex IBD care. For more educational content, visit the GHAPP Digital Hub and the GHAPP ACE app.