P1158 - The Changing Landscape of Biologic Therapy in IBD: How Patient Preference for Subcutaneous Formulations Are Reshaping Ambulatory Infusion Centers (AIC): Single Center Survey Results From a High-Volume Community-Based AIC

Parth Jain, ¹, Randy Eaton, MBA¹, Chris Fourment, MD², Laken Daniels, RN¹, Nathan Ducat, RN¹, Taylor Fernandez, RN¹, Angela Fly, RN¹, Benjamin Pappuleas, RN¹, William H. Holderman, MD¹
1Washington Gastroenterology, Tacoma, WA; 2Gastro Health, Southlake, TX

Introduction: Intravenous (IV) and subcutaneous (SC) biologic therapies have transformed the management of moderate-to-severe ulcerative colitis (UC) and Crohn’s disease (CD). Traditionally, patients receive induction and maintenance therapy via IV infusions delivered in ambulatory infusion centers (AICs). The growing availability of SC maintenance options, evolving prescribing practices, payer mandates, and patient-driven preferences, is catalyzing a fundamental shift in treatment paradigms. Understanding the willingness of patients currently maintained on IV therapy to transition to SC formulations is essential to forecast adoption trends and proactively address the operational and financial challenges this transition may pose to AICs.

Methods: A survey of 113 patients receiving maintenance therapy for UC or CD at a community-based, 4650 infusions/year, vertically integrated practice in the Pacific Northwest, was conducted between September 2024 and February 2025.

Results: Respondents mean age 48, 52% females, 48% males: CD 49%, UC 38%, 41% reported disease duration over 10 years. IV therapies included vedolizumab 48% and anti-TNF agents 42%. 48% would switch to SC therapy, 22% would not, 30% were unsure, 63% did not have enough education to switch. Women were more likely to consider switching than men (59% vs 28%). Concerns were perceived lower effectiveness 60%, side effects 40%, challenges with self-administration 46%. Motivators included convenience 68%, reduced infusion time 68%, less impact daily life 14%, IV access issues 12%. Infusion visits were considered convenient or very convenient by 73%, 11% found them inconvenient. 59% reported infusions did not affect daily life: 29% experienced occasional impact. Flexibility in SC treatment was important or very important to 60%, and 42% identified frequent dosing—particularly weekly 30%—as a barrier. Satisfaction with current therapy was high: 62% very satisfied, 22% satisfied; only 21% reported side effects.

Discussion: Nearly half of patients are open to transitioning to SC maintenance therapy, though concerns about efficacy, safety, and self-administration remain. Women demonstrated greater interest in SC options. Despite general satisfaction with current infusion experiences, many reported life impacts and valued convenience of SC. Increasing SC adoption may reduce AIC volume, impacting staffing and financial sustainability. Proactive planning will be essential to adapt workflows and sustain care delivery in an SC-dominated treatment landscape.

Disclosures:
Parth Jain indicated no relevant financial relationships.
Randy Eaton indicated no relevant financial relationships.
Chris Fourment indicated no relevant financial relationships.
Laken Daniels indicated no relevant financial relationships.
Nathan Ducat indicated no relevant financial relationships.
Taylor Fernandez indicated no relevant financial relationships.
Angela Fly indicated no relevant financial relationships.
Benjamin Pappuleas indicated no relevant financial relationships.
William Holderman indicated no relevant financial relationships.

Parth Jain, ¹, Randy Eaton, MBA¹, Chris Fourment, MD², Laken Daniels, RN¹, Nathan Ducat, RN¹, Taylor Fernandez, RN¹, Angela Fly, RN¹, Benjamin Pappuleas, RN¹, William H. Holderman, MD¹. P1158 - The Changing Landscape of Biologic Therapy in IBD: How Patient Preference for Subcutaneous Formulations Are Reshaping Ambulatory Infusion Centers (AIC): Single Center Survey Results From a High-Volume Community-Based AIC, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.