Treatment retention ‘high’ after infliximab biosimilar-to-biosimilar switch
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PHILADELPHIA — Patients who switched from one infliximab biosimilar to another experienced comparable treatment retention rates, according to data presented at ACR Convergence 2022.
“Biosimilars play an important role in treating patients with rheumatic diseases,” Hafsah Nabi, MD, of the DANBIO and Copenhagen Center for Arthritis Research (COPECARE), the Center for Rheumatology and Spine Diseases, and the Center of Head and Orthopedics at Rigshospitalet, in Copenhagen, Denmark, told attendees. “Despite the widespread use, we still have questions in our clinic every day.”
Nabi suggested that that minimal investigation has been performed into outcomes associated with switching from one infliximab (Remicade, Janssen) biosimilar to a second infliximab biosimilar in patients with rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.
“Randomized, controlled trials and real-life data sets are needed,” she said.
In the current observational cohort study using data from the DANBIO registry, patients with the RA, PsA and axial SpA who were switched from CT-P13 (Inflectra, Pfizer) to GP1111 (Zessly, Sandoz) between April 1, 2019, and Feb. 1, 2020, underwent analysis. They were stratified based on whether they were originator-naïve or originator-experienced.
Treatment retention at 1 year with GP1111 served as the primary endpoint, along with changes in disease activity 4 months before vs. 4 months after switch in individual patients. Clinical factors at baseline also were included in the analysis.
The total patient population was 1,605, which included 685 patients with RA, 314 with PsA and 606 with axial SpA. The median disease duration in the group was 9 years, with 37% in CDAI/ASDAS remission. In addition, 1,171 patients fell into the originator-naïve category, while the remaining 434 were experienced with the originator.
Nabi noted that patients in the originator-naïve group tended to be younger, with a shorter disease duration and a higher baseline disease activity compared with infliximab-experienced patients.
Results showed that retention rates of GP111 at 1 year were 83% (95% CI, 81% to 85%) in the originator-naïve group and 92% (95% CI, 90% to 95%) for originator-experienced group.
Further findings demonstrated that changes in disease activity 4 months pre- and post-switch were close to zero for several disease activity measures, including DAS28, ASDAS and VAS pain score, according to the findings.
Compared with the infliximab-naïve group, experience with the originator was associated with higher GP1111 retention among patients with RA (HR = 0.4; 95%CI, 0.2-0.7) and PsA (HR = 0.2; 95% CI, 0.1-0.8), according to Nabi. This trend was not observed among patients with axial SpA (HR = 0.6; 95% CI, 0.3-1.2).
“We report the effectiveness of infliximab biosimilar-to-biosimilar treatment retention,” Nabi said. “Overall, the retention was high.”
Because of the differences in baseline demographics, Nabi and colleagues drew one other important conclusion about their findings: “This indicates that treatment outcomes may be affected by patient-related rather than drug-related factors,” she said.
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Nabi H. Abstract 1112. Presented at: ACR Convergence 2022; Nov. 11-14, 2022; Philadelphia (hybrid meeting).
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