{"id":58949,"date":"2025-02-13T18:00:08","date_gmt":"2025-02-13T18:00:08","guid":{"rendered":"https:\/\/cdhf.staging.not4prod.com\/?p=58949"},"modified":"2025-02-18T14:09:36","modified_gmt":"2025-02-18T14:09:36","slug":"infliximab-for-the-treatment-of-inflammatory-bowel-disease-an-overview-of-drug-history-and-delivery","status":"publish","type":"post","link":"https:\/\/cdhf.ca\/en\/infliximab-for-the-treatment-of-inflammatory-bowel-disease-an-overview-of-drug-history-and-delivery\/","title":{"rendered":"Infliximab for the Treatment of Inflammatory Bowel Disease: An Overview of Drug History and Delivery"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><strong>What is Infliximab and where did it come from?&nbsp;<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Infliximab is a medication used to treat inflammatory bowel disease (<a href=\"https:\/\/cdhf.ca\/en\/tag\/tags-ibd\/\">IBD<\/a>), including both Crohn&#8217;s disease and ulcerative colitis.\u202fThe initial formulation of infliximab known as Remicade<sup>\u00e2<\/sup> has been used for over twenty years, gaining approval in Canada for the treatment of Crohn\u2019s disease in 2001 and Ulcerative Colitis in 2006<sup>1<\/sup>. With its longstanding use, infliximab is well studied and known to be effective at achieving and maintaining control of IBD, allowing patients to feel better and stay better for a long time while decreasing their need for surgery<sup>2-4<\/sup>. In addition to treating inflammation in the bowel, infliximab is effective at treating fistulas, which are abnormal connections between the intestines and the skin or other organs<sup>5<\/sup>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Infliximab is also known to be effective at treating extra-intestinal manifestations of IBD including skin changes, and inflammation in the eyes and joints<sup>6<\/sup>. Over the years, many studies have looked at the long-term safety of infliximab.\u202fThese studies found that while it is generally safe, it can cause some side effects including infections and allergic reactions. These side effects are rare, and risk can be reduced with proper preventative measures<sup>7<\/sup>.&nbsp;&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Infliximab for Inflammatory Bowel Disease\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/zgw_bXeRgLE?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>How does Infliximab work?&nbsp;<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In people with IBD, the immune system mistakenly attacks the digestive tract, causing inflammation. Infliximab works by targeting a specific protein in the body called tumor necrosis factor-alpha (TNF-\u03b1). TNF-\u03b1 is a substance in the body that causes inflammation, which is a part of the immune system&#8217;s response to injury or infection. Infliximab helps by blocking TNF-\u03b1, which reduces inflammation and helps the digestive tract heal. It does this by binding to TNF-\u03b1 and preventing it from attaching to its receptors on cells. This stops the chain reaction that leads to inflammation. Infliximab also helps reduce the activity of certain white blood cells in the immune system which are involved in the inflammatory process. By reducing the activity of these cells, infliximab helps decrease the overall immune response and inflammation in the digestive tract<sup>8<\/sup>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What are Biosimilars?&nbsp;<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When a biologic is first produced and approved for use, it is referred to as an \u201coriginator\u201d, as it is the original version of a biologic used to treat a disease. It takes a significant amount of time and money to develop a new biologic, and therefore to help pay for this cost and promote research, new biologics are protected by patent in Canada for a period of twenty years. This means that during this time, no other companies can produce biosimilar medications. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/cdhf.ca\/en\/biosimilars-initiatives\/\">Biosimilars<\/a> are medications that are made by different companies after the original patent expires. They are designed to be very similar to the originator biologic and have the same effect, but are made using different processes, and therefore are not exactly the same. As previously mentioned, Remicade<sup>\u00e2<\/sup> was the originator infliximab biologic, and following expiration of its patent, various infliximab biosimilars were approved in Canada including Inflectra in 2016&nbsp; as well as Renflexis in 2017&nbsp; Despite small differences, studies have shown that infliximab biosimilars are just as safe and effective as Remicade<sup>\u00e2<\/sup>. They have similar effects on the body and help control inflammation in the same way. Using infliximab biosimilars can also help lower the cost of treatment, making it more affordable<sup>9-10<\/sup>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>How is Infliximab given?&nbsp;<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Infliximab, including its biosimilars and the originator Remicade<sup>\u00e2<\/sup> is typically given intravenously, which means it is directly delivered into the blood stream. This process is often done at a clinic, hospital, or infusion center. The medication is typically given at weeks zero, two, and six, and then every eight weeks onward<sup>11<\/sup>. Ongoing infusions may be given more frequently if a patient\u2019s Gastroenterologist decides this is needed.&nbsp;&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"How Infliximab Helps in IBD\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/eo2Rb69DFqI?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is Subcutaneous Infliximab?&nbsp; <\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In 2024, Health Canada approved RemsimaTM<sup> <\/sup>SC, the first subcutaneous formulation of an infliximab biosimilar available for use in Canada for the treatment of IBD<sup>12<\/sup>. As a subcutaneous formulation, Remsima<sup>TM<\/sup> SC is administered using a self-injector device usually given into the thigh, abdomen, or upper arm. To start a patient on subcutaneous infliximab, they begin with an intravenous induction phase. This involves receiving 5mg\/kg intravenous infliximab at weeks zero, two, and six to quickly reduce inflammation. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After this induction phase, the patient can be treated with the subcutaneous form for treatment maintenance with injections starting at week eight, with ongoing injections every two weeks. Patients who are already being treated with intravenous infliximab maintenance therapy can be switched over at any time to Remsima SC<sup>13<\/sup>.&nbsp; Real world evidence studies and registrational controlled trials in IBD patients have shown that subcutaneous infliximab is well tolerated and effective at getting patients with IBD to feel better and stay better for a long time<sup>14-21<\/sup>.&nbsp;&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"Infliximab: IV &amp; Subcutaneous \u2013 What You Need to Know!\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/rmd1bca8QM8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Who should consider Subcutaneous Infliximab?<\/strong>&nbsp;<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Subcutaneous infliximab is an option for patients and caregivers hoping to administer their medication at home, without the need to travel to a clinic, hospital, or infusion center. Alternatively, some patients who are not comfortable with self-injection of medications may prefer intravenous formulations that are more hands-off, and administered by a nursing team.&nbsp; Either way, the patient can be assured they are receiving the same infliximab \u2018molecule\u2019\/medication, which has been used in medical practice for over ten years.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While studies have shown that subcutaneous infliximab is effective, there are some people for whom it may not be the right choice. Studies have shown that individuals receiving larger and more frequent doses of intravenous Infliximab (i.e. 10 mg\/kg every four weeks) are at an increased risk of relapse when switching from intravenous to subcutaneous formulations at the approved dosing of 120mg every two weeks (120mg q2w)<sup>15-16<\/sup>. Clinical data suggested that most of these patients who relapsed at the approved dose of 120mg every 2 weeks could be recaptured by increasing the dose to either 240mg every 2 weeks or 120 mg weekly<sup>15-16<\/sup>. The recommendation is that these patients on infliximab IV maintenance at 10 mg\/kg every four weeks should immediately start at 240mg every 2 weeks or 120 mg weekly when switched to subcutaneous infliximab.&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Overall: <\/strong>Infliximab is an extensively studied, well tolerated, and effective medication for the treatment of inflammatory bowel disease.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Jan31_V1_Celltrion-Infographics-1-791x1024.webp\" alt=\"\" class=\"wp-image-58954 lazyload\" style=\"width:636px;height:auto\"\/><noscript><img decoding=\"async\" src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Jan31_V1_Celltrion-Infographics-1-791x1024.webp\" alt=\"\" class=\"wp-image-58954 lazyload\" style=\"width:636px;height:auto\"\/><\/noscript><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Jan31_V1_Celltrion-Infographics-2-791x1024.png\" alt=\"\" class=\"wp-image-58956 lazyload\" style=\"width:678px;height:auto\"\/><noscript><img decoding=\"async\" width=\"791\" height=\"1024\" src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Jan31_V1_Celltrion-Infographics-2-791x1024.png\" alt=\"\" class=\"wp-image-58956 lazyload\" style=\"width:678px;height:auto\"\/><\/noscript><\/figure>\n<\/div>\n\n<div style=\"gap: 20px\" class=\"align-button-center ub-buttons orientation-button-row ub-flex-wrap wp-block-ub-button\" id=\"ub-button-32597bca-5f90-45d7-b112-5b8c38ad5309\"><div class=\"ub-button-container\">\n\t\t\t<a href=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Jan31_V1_Celltrion-Infographics.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"ub-button-block-main   ub-button-flex\" role=\"button\" style=\"--ub-button-background-color: #313131; --ub-button-color: #ffffff; --ub-button-border: none; --ub-button-hover-background-color: #313131; --ub-button-hover-color: #ffffff; --ub-button-hover-border: none; padding-top: 10px; padding-right: 10px; padding-bottom: 10px; padding-left: 10px; border-top-left-radius: 10px;; border-top-right-radius: 10px;; border-bottom-left-radius: 10px;; border-bottom-right-radius: 10px;; \">\n\t\t\t\t<div class=\"ub-button-content-holder\" style=\"flex-direction: row\">\n\t\t\t\t\t<span class=\"ub-button-block-btn\">Download the &#8216;Infliximab for IBD&#8217; Infographic!<\/span>\n\t\t\t\t<\/div>\n\t\t\t<\/a>\n\t\t<\/div><\/div>\n\n<div class=\"gradient-divider\"><\/div><div class=\"sponsor-block\"><p><p>This information was made possible by <a href=\"https:\/\/www.celltrionhealthcare.ca\/\">Celltrion Healthcare.<\/a><\/p><\/p><div class=\"sponsor-details\"><div class=\"photo\" >\n<a target=\"_blank\" href=\"https:\/\/celltrionhealthcare.ca\/\"><img decoding=\"async\" class=\"lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" data-src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Celltrionhealthcare_500px-scaled.webp\"  \/><noscript><img decoding=\"async\" class=\"lazyload\" src=\"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/Celltrionhealthcare_500px-scaled.webp\"  \/><\/noscript><\/a>\n<\/div>\n        <\/div><\/div>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">About the Authors:<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Dr.\u00a0Cathy\u00a0Lu\u00a0is an IBD gastroenterologist and assistant professor of medicine at the University of Calgary. She completed her internal medicine and gastroenterology residency at the University of Alberta. She has also completed a joint advanced IBD fellowship with specialization in intestinal ultrasound. Her primary research interests are in strictures in Crohn&#8217;s disease, intestinal ultrasound, and\u00a0biomarkers in diagnosis, monitoring, and treatment response in IBD.<br>Patrick Hamilton is a first-year Gastroenterology fellow at the University of Calgary. He completed medical school at the University of Alberta, and Internal Medicine residency at the University of Calgary. He has plans to undergo further subspeciality training within the field of inflammatory bowel disease.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Citations:<\/strong>&nbsp;<\/h3>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>Melsheimer R, Geldhof A, Apaolaza I, Schaible T. Remicade\u00ae(infliximab): 20 years of contributions to science and medicine. Biologics: Targets and Therapy. 2019 Jul 30:139-78.&nbsp;<\/li>\n\n\n\n<li>Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J, Travers S, Rachmilewitz D, Hanauer SB, Lichtenstein GR, De Villiers WJ. Infliximab for induction and maintenance therapy for ulcerative colitis. New England Journal of Medicine. 2005 Dec 8;353(23):2462-76.&nbsp;<\/li>\n\n\n\n<li>Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, Rachmilewitz D, Wolf DC, Olson A, Bao W, Rutgeerts P. Maintenance infliximab for Crohn&#8217;s disease: the ACCENT I randomised trial. The Lancet. 2002 May 4;359(9317):1541-9.&nbsp;<\/li>\n\n\n\n<li>Noor NM, Lee JC, Bond S, Dowling F, Brezina B, Patel KV, Ahmad T, Banim PJ, Berrill JW, Cooney R, Negro JD. A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn&#8217;s disease (PROFILE): a multicentre, open-label randomised controlled trial. The Lancet Gastroenterology &amp; Hepatology. 2024 May 1;9(5):415-27.&nbsp;<\/li>\n\n\n\n<li>Sands BE, Anderson FH, Bernstein CN, Chey WY, Feagan BG, Fedorak RN, Kamm MA, Korzenik JR, Lashner BA, Onken JE, Rachmilewitz D. Infliximab maintenance therapy for fistulizing Crohn&#8217;s disease. New England Journal of Medicine. 2004 Feb 26;350(9):876-85.&nbsp;<\/li>\n\n\n\n<li>Peyrin-Biroulet L, Van Assche G, G\u00f3mez-Ulloa D, Garcia-Alvarez L, Lara N, Black CM, Kachroo S. Systematic review of tumor necrosis factor antagonists in extraintestinal manifestations in inflammatory bowel disease. Clinical Gastroenterology and Hepatology. 2017 Jan 1;15(1):25-36.&nbsp;<\/li>\n\n\n\n<li>Zabana Y, Dom\u00e8nech E, Ma\u00f1osa M, Garcia\u2010Planella E, Bernal I, Cabr\u00e9 E, Gassull MA. Infliximab safety profile and long\u2010term applicability in inflammatory bowel disease: 9\u2010year experience in clinical practice. Alimentary pharmacology &amp; therapeutics. 2010 Mar;31(5):553-60.&nbsp;<\/li>\n\n\n\n<li>Ebert EC. Infliximab and the TNF-\u03b1 system. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2009 Mar;296(3):G612-20.&nbsp;<\/li>\n\n\n\n<li>Zeng Z, Lin H, Jiang M, Yuan J, Li X, Jia Y, Yang L, Zhang H. Anti-TNF\u03b1 in inflammatory bowel disease: from originators to biosimilars. Frontiers in Pharmacology. 2024 Jul 24;15:1424606.&nbsp;<\/li>\n\n\n\n<li>Guidelines on evaluation of Biosimilars [Internet]. World Health Organization; 2022 [cited 2024 Dec 16]. Available from: <a href=\"https:\/\/www.who.int\/publications\/m\/item\/guidelines-on-evaluation-of-biosimilars\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.who.int\/publications\/m\/item\/guidelines-on-evaluation-of-biosimilars<\/a>&nbsp;&nbsp;<\/li>\n\n\n\n<li>DailyMed &#8211; inflectra- infliximab-dyyb injection, powder, lyophilized, for solution [Internet]. National Institutes of Health; 2024 [cited 2024 Dec 16]. Available from: https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=37eaca10-d812-48bc-8b8e-b836bfa9968f &nbsp;<\/li>\n\n\n\n<li>Regulatory Decision Summary for Remsima SC [Internet]. Government of Canada; 2024 [cited 2024 Dec 16]. Available from: <a href=\"https:\/\/dhpp.hpfb-dgpsa.ca\/review-documents\/resource\/RDS1708630999500\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/dhpp.hpfb-dgpsa.ca\/review-documents\/resource\/RDS1708630999500\/<\/a>&nbsp;&nbsp;<\/li>\n\n\n\n<li>Infliximab (Remsima SC) Therapeutic Area: Crohn Disease and ulcerative colitis: CADTH Reimbursement Review [Internet]. U.S. National Library of Medicine; 2024 [cited 2024 Dec 16]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK607353\/ &nbsp;<\/li>\n\n\n\n<li>Hanauer SB, Sands BE, Schreiber S, Danese S, K\u0142opocka M, Kierku\u015b J, Kulynych R, Gonciarz M, So\u0142tysiak A, Smoli\u0144ski P, Sre\u0107kovi\u0107 S. Subcutaneous Infliximab (CT-P13) as Maintenance Therapy for Inflammatory Bowel Disease: 2 Randomized Phase 3 Trials. Gastroenterology. 2024 May 23.&nbsp;<\/li>\n\n\n\n<li>Buisson A, Nachury M, Reymond M, Yzet C, Wils P, Payen L, Laugie M, Manlay L, Mathieu N, Pereira B, Fumery M. Effectiveness of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel diseases: the REMSWITCH study. Clinical Gastroenterology and Hepatology. 2023 Aug 1;21(9):2338-46.&nbsp;<\/li>\n\n\n\n<li>Buisson A, Nachury M, Bazoge M, Yzet C, Wils P, Dodel M, Coban D, Pereira B, Fumery M. Long\u2010term effectiveness and acceptability of switching from intravenous to subcutaneous infliximab in patients with inflammatory bowel disease treated with intensified doses: The REMSWITCH\u2010LT study. Alimentary Pharmacology &amp; Therapeutics. 2024 Feb;59(4):526-34.&nbsp;<\/li>\n\n\n\n<li>Schreiber SW, Ben-Horin S, Leszczyszyn J, Dudkowiak R, Lahat A, Gawdis-Wojnarska B, et al. Randomized controlled trial: subcutaneous vs intravenous infliximab CT-P13 maintenance in inflammatory bowel disease. Gastroenterology. 2021;160(7):2340-2353.&nbsp;<\/li>\n\n\n\n<li>Smith PJ, Critchley L, Storey D, et al. Efficacy and safety of elective switching from intravenous to subcutaneous infliximab [CT-P13]: a multicentre cohort study. J Crohns Colitis. 2022;16(9):1436-1446.&nbsp;<\/li>\n\n\n\n<li>Cummings F, Buisson A, Smith PJ, et al. Effectiveness of switching from intravenous to subcutaneous infliximab in Inflammatory Bowel Disease patients: A combined analysis of real-world evidence. ECCO 2024; Abstract P712.&nbsp;<\/li>\n\n\n\n<li>Kim K, Hong SN, Kang SB, et al. Clinical efficacy and durability of subcutaneous infliximab in patients with inflammatory bowel disease after switching from intravenous in a Korean multicenter prospective cohort study. ECCO 2024; Abstract and Poster P513.&nbsp;<\/li>\n\n\n\n<li>Mahmood T et al. United European Gastroenterol J. 2023; 11(9):922-923, LB02 at EUG Week, 2023&nbsp;<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What is Infliximab and where did it come from?&nbsp;&nbsp; Infliximab is a medication used to treat inflammatory bowel disease (IBD), including both Crohn&#8217;s disease and ulcerative colitis.\u202fThe initial formulation of infliximab known as Remicade\u00e2 has been used for over twenty years, gaining approval in Canada for the treatment of Crohn\u2019s disease in 2001 and Ulcerative [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":58964,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"cdhf2022_sponsors_meta":[],"footnotes":""},"categories":[60,75,74],"tags":[52],"class_list":["post-58949","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","category-infographic","category-video","tag-tags-ibd"],"acf":{"article_writer":[58966,58967]},"featured_image_src":"https:\/\/cdhf.ca\/wp-content\/uploads\/2025\/02\/infliximab-banner.webp","author_info":{"display_name":"Sophie Allan","author_link":"https:\/\/cdhf.ca\/en\/author\/sophie-allen\/"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - 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