In Switching to Biosimilar Infliximab in IBD, Rapid Infusion Protocols Are Safe

As more centers begin to switch patients from reference infliximab to biosimilar options, patients who have benefitted from rapid infusions of the reference product may want to continue to receive time-saving infusions that reduce the burden of lengthy visits to infusion centers.

A new study sought to evaluate the safety and outcomes of continuing rapid infusion protocols after a switch to biosimilar infliximab.

In a healthcare system that switched all eligible patients with inflammatory bowel disease (IBD) to CT-P13 (Inflectra) from the reference, all patients in the switch cohort (n = 76) who had been receiving rapid infusions of 30 minutes each were compared with a parallel cohort of patients who had received the biosimilar since initiating therapy (n = 44).

Baseline characteristics were comparable across the groups, with the exceptions of higher immunomodulator use among the maintenance cohort and a longer duration of therapy among the switch cohort. No changes were made to patients’ premedications or infusion rates. Patients were prospectively assessed for adverse events (AEs), disease activity, and drug levels.

Baseline infliximab levels before the switch were subtherapeutic in 23% of patients and supratherapeutic in 30%. During a median follow-up of 2 infliximab infusions after the switch, the investigators found no significant AEs, including infusion-related reactions, associated with rapid infusion of the biosimilar.

The authors write that rapid infusion continued through a switch to biosimilar infliximab appears to be safe and effective, and they add that switching also represents an opportunity for physicians to reassess patients’ disease activity and infliximab trough levels to inform clinical decision making.

Previous studies of rapid infusion protocols in other disease states with other biosimilars have also demonstrated that patients can continue to receive rapid infusions after a switch. A 2017 study in patients receiving rituximab showed that patients could be safely switched from the reference product to a rituximab biosimilar without reverting to slower infusion rates.

Reference

Srinivasan A, van Langenberg DR, Haar G, Milller C, Rodrigues B. Rapid 30-minute infliximab infusion protocols when switching inflammatory bowel disease (IBD) patients from originator to biosimilar infliximab. Presented at: Digestive Disease Week 2019; San Diego, CA; May 18-21, 2019. Abstract Su1847.