More UK Evidence Documents Successful Switching to Biosimilar Infliximab

In the United Kingdom, where switching patients to biosimilars has become more common as National Health Service trusts seek to benefit from cost savings, multiple reports have noted the feasibility of switching patients to biosimilar infliximab.

During the 83rd Annual Scientific Meeting of the American College of Gastroenterology, researchers from the United Kingdom reported on yet another large, nonmedical switch from reference infliximab to biosimilar CT-P13 (Inflectra, Remsima), this time in the Pennine Acute Hospitals Trust.

The research team, led by Anirudh Pramod Bhandare, MBBS, MD, performed a retrospective review of patients with inflammatory bowel disease who were switched from the reference product to the biosimilar, and analyzed disease demographics, the clinical course of disease, and outcomes until the time of the last follow-up.

In total, 96 patients were switched, 44 of whom had ulcerative colitis (UC) and 52 of whom had Crohn disease (CD). The mean age at diagnosis was 34.73 years. The mean duration of treatment with the reference was 49.8 months, and the mean duration of treatment with the biosimilar at the time of the review was 7.9 months.

At the time of the switch, 76 patients had normal C-reactive protein (CRP) levels, while 15 patients had elevated levels. At follow-up, 14 patients had an increase in CRP. Eighty patients remained in biochemical remission.

In 31 patients, therapeutic drug monitoring was performed. In 28 patients, infliximab was maintained in the therapeutic range, while 3 patients required dose intensification.

At the time of the last follow-up, 72 patients (34 with UC and 38 with CD) were in clinical remission, and 31 patients (13 with UC and 18 with CD) had achieved mucosal healing.

The investigators concluded that biosimilar infliximab was well tolerated and maintained efficacy in patients who switched, which indicates that switching can “fulfill the purported aims of improving access to treatment and reducing costs.”

Reference

Bhandare AP, Nigam GB, Nayeemudin S, Limdi JK. Efficacy and tolerability of a biosimilar infliximab switch—a large single-centre experience from the U.K. Presented at the 83rd Annual Scientific Meeting of the American College of Gastroenterology, October 5-10, 2018; Philadelphia, Pennsylvania. Abstract 676. https://www.nature.com/articles/s41395-018-0296-0.pdf.