Biosimilar retention not impacted by comorbidities in inflammatory RMDs
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Key takeaways:
- Inflammatory RMD comorbidities had no impact on the retention of biosimilar adalimumab after a non-medical switch from the originator.
- Cardiovascular comorbidities were the most common.
The presence of comorbidities with inflammatory rheumatic musculoskeletal diseases made little difference in biosimilar retention after a non-medical switch, according to data published in Arthritis Research & Therapy.
“Comorbidity has recently gained much attention in patients with [rheumatic musculoskeletal diseases (RMD)], since it may not only increase morbidity and mortality of RMD patients, especially in chronic inflammatory states, but also confound disease activity and limit drug intake,” Imke Redeker, MSc, of the Ruhr-Universität Bochum, in Germany, and colleagues wrote.
“Data on bDMARDs retention in patients with and without comorbidities is scarce,” they added.
To analyze how comorbidities impact non-medical switches from adalimumab (Humira, Abbvie) to a biosimilar — ABP501 (Amjevita, Amgen) — among patients with inflammatory RMDs, Redeker and colleagues conducted a retrospective chart review of 121 patients treated at their center, including 68 with axial spondyloarthritis, 23 with rheumatoid arthritis and 15 with psoriatic arthritis.
The included patients had been treated with adalimumab and switched to ABP501 for non-medical reasons. The researchers used Bayesian exponential regression to compare biosimilar retention rates through 6 months between patients with lower or higher scores on the Charlson Comorbidity Index.
Six months after switching to ABP501, 74.8% of patients continued with it, while 10.8% changed to another biosimilar, 7.2% switched back to adalimumab and 3.6% switched to a different biologic, according to the researchers. At baseline, 38% of patients demonstrated a Charlson Comorbidity Index Score of zero. Among them, 74% continued ABP501 after 6 months, while 76% of patients who scored above zero continued it.
The Bayesian analysis revealed “only a small difference” in the rate of ABP501 continuation between the two groups (estimate 0.0012; 95% CI, –0.0337 to 0.0361), the researchers wrote. The most prevalent comorbidities were cardiovascular (40%), followed by diseases of the skin (33%), gastrointestinal tract (20%) and eye (20%).
“To the best of our knowledge, this is the first study to evaluate comorbidity as a risk factor for discontinuation of the [biosimilar DMARD] ABP after non-medical switching from originator [adalimumab] in patients with inflammatory RMD,” Redeker and colleagues wrote.
“There was no evidence of impaired retention to [adalimumab biosimilar DMARD] in a non-medical switch scenario with a follow-up period of 6 months in RMD patients with comorbidities compared to those without,” they added. “However, only 38% of our patients had a [Charlson Comorbidity Index score greater than zero] — indicating a relatively healthy and/or well-treated cohort.”
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