While both the biosimilar filgrastim and biosimilar pegfilgrastim were effective in reducing the incidence of neutropenia, adverse events related to granulocyte-colony stimulating factor therapy were significantly higher in patients who received pegfilgrastim.
In Iran, where biosimilar filgrastim and biosimilar pegfilgrastim are available to patients, both agents are used for the prophylaxis of neutropenia in patients with breast cancer who are undergoing myelosuppressive chemotherapy. The longer-acting nature of pegfilgrastim, and its single-dose administration, offers convenience over multiple doses of filgrastim, but the grade of neutropenia and adverse events (AEs) associated with the 2 available products, according to a recent study, have not yet been compared in a crossover pattern.
The study, conducted at 2 centers in Iran, compared 24 patients’ grade of neutropenia and AEs after receiving biosimilar filgrastim (Zarxio) and biosimilar pegfilgrastim (Pegagen, a product manufactured by CinnaGen and approved in Iran).
Click to read more about CinnaGen’s biosimilars.
The patients, all of whom were being treated with dose-dense chemotherapy, were randomly assigned to 2 arms. The first arm received 6 mg of pegfilgrastim 24 hours after the first cycle of chemotherapy, followed by a daily subcutaneous dose of 300 μg of filgrastim for 6 days after the second cycle of chemotherapy. The second arm was treated with daily filgrastim after the first cycle of chemotherapy, then with pegfilgrastim after the second cycle.
One week after the first cycle of chemotherapy, the mean level of white blood cells (WBCs) was 5149 in the filgrastim group and 4556 in the pegfilgrastim group. Two weeks post chemotherapy, the mean WBC count for the 2 groups was 4422 and 9311, respectively, suggesting that pegfilgrastim was more protective against neutropenia than filgrastim was. However, the same parameters were measured after the second course of chemotherapy, and no significant difference was found; crossover analysis showed no significant difference in cell blood count parameters between the 2 groups.
The investigators also measured the total AEs reported with use of filgrastim and pegfilgrastim, and found significant differences in gastrointestinal side effects and bone pain. While 29.2% of patients receiving pegfilgrastim reported nausea and abdominal pain, no patients receiving filgrastim reported the same. With respect to bone pain, 20.8% of patients receiving pegfilgrastim reported this AE, while none of the patients receiving filgrastim did so.
The authors conclude that, while both the biosimilar filgrastim and biosimilar pegfilgrastim were effective in reducing the incidence of neutropenia, AEs related to granulocyte-colony stimulating factor therapy were significantly higher in patients who received pegfilgrastim.
Reference
Ashrafi F, Salmasi M. Comparison of the effects of pegylated granulocyte-colony stimulating factor and granulocyte-colony stimulating factor on cytopenia induced by dose-dense chemotherapy in breast cancer patients. J Res Med Sci. 2018;23:73. doi: 10.4103/jrms.JRMS_463_17.
What Clinicians Need to Know About Using Biosimilars to Treat IBD
April 13th 2024A review article, intended to act as a guide for clinicians, summarizes the available infliximab and adalimumab biosimilars for treating inflammatory bowel disease (IBD) as well as others that are coming down the pipeline.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
Study: More Biosimilar Competition Is Not Lowering Patient OOP Costs
March 29th 2024Despite more biosimilars entering the market and generating significant savings for payers and health care systems, these savings are not resulting in lower out-of-pocket (OOP) costs for patients, according to a recent study.
Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars
April 16th 2023What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.
The Role of Biosimilars: Advancing Access, Financial Health, and System Sustainability
March 11th 2024Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, a member of the Community Oncology Alliance, and member of The Center for Biosimilars® Advisory Board, glances back at the development of the biosimilar industry and the last 5 years of progress.