1
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Murray GM, Griffith N, Sinnappurajar P, Al Julandani DA, Clarke SLN, Hawley DP, Choi J, Guly CM, Ramanan AV. Clinical Efficacy of Biosimilar Switch of Adalimumab for Management of Uveitis. Ocul Immunol Inflamm 2024; 32:442-446. [PMID: 36803373 PMCID: PMC11057845 DOI: 10.1080/09273948.2023.2172591] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Adalimumab has demonstrated efficacy in non-infectious uveitis. With the introduction of biosimilar agents such as Amgevita, we aimed to quantify efficacy and tolerability compared to Humira in a multi-centre UK cohort. METHODS Patients identified from tertiary uveitis clinics in 3 centres, after institution-mandated switching was implemented. RESULTS Data collected for 102 patients, aged 2-75 years, with 185 active eyes. Following switch, rates of uveitis flare were not significantly different (13 events before, 21 after, p = .132). Rates of elevated intraocular pressure were decreased (32 before, 25 afterwards, p = .006) and dosing of oral and intra-ocular steroids was stable. Twenty-four patients (24%) requested to return to Humira, commonly due to pain from injection or technical difficulty with the device. CONCLUSION Amgevita is safe and effective for inflammatory uveitis with non-inferiority to Humira. Significant numbers of patients requested to switch back due to side effects including injection site reactions.
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Affiliation(s)
- G. M. Murray
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - N. Griffith
- Department of Ophthalmology Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - P. Sinnappurajar
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - D. A. Al Julandani
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - S. L. N. Clarke
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- MRC Integrative Epidemiology Unit and School of Population Health Sciences, University of Bristol, Bristol, UK
| | - D. P. Hawley
- Department of Rheumatology Sheffield Children’s NHS Foundation Trust, Sheffield, UK
| | - J. Choi
- Department of Ophthalmology Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
- Department of Rheumatology Sheffield Children’s NHS Foundation Trust, Sheffield, UK
| | - C. M. Guly
- Department of Ophthalmology University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Athimalaipet V. Ramanan
- Department of Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, UK
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2
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Sydor AM, Bergin E, Kay J, Stone E, Popovian R. Modeling the Effects of Formulary Exclusions: How Many Patients Could Be Affected by a Specific Exclusion? JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2024; 11:86-93. [PMID: 38544720 PMCID: PMC10970716 DOI: 10.36469/001c.94544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/29/2024] [Indexed: 05/20/2024]
Abstract
Background: Medication formularies, initially designed to promote the use of cost-effective generic drugs, are now designed to maximize financial benefits for the pharmacy benefit management companies that negotiate purchase prices. In the second-largest pharmacy benefit management formulary that is publicly available, 55% of mandated substitutions are not for generic or biosimilar versions of the same active ingredient and/or formulation and may not be medically or financially beneficial to patients. Methods: We modeled the effect of excluding novel agents for atrial fibrillation/venous thromboembolism, migraine prevention, and psoriasis, which all would require substitution with a different active ingredient. Using population data, market share of the 2 largest US formularies, and 2021 prescription data, we calculated how many people could be affected by such exclusions. Using data from the published literature, we calculated how many of those individuals are likely to discontinue treatment and/or have adverse events due to a formulary exclusion. Results: The number of people likely to have adverse events due to the exclusion could be as high as 1 million for atrial fibrillation/venous thromboembolism, 900 000 for migraine prevention, and 500 000 for psoriasis. The numbers likely to discontinue treatment for their condition are as high as 924 000 for atrial fibrillation/venous thromboembolism, 646 000 for migraine, and 138 000 for psoriasis. Conclusion: Substitution with a nonequivalent treatment is common in formularies currently in use and is not without substantial consequences for hundreds of thousands of patients. Forced medication substitution results in costly increases in morbidity and mortality and should be part of the cost-benefit analysis of any formulary exclusion.
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Affiliation(s)
- Anne M. Sydor
- 1. Division of Patient-Focused Economic and Policy ResearchGlobal Healthy Living Foundation, Upper Nyack, New York, USA
| | - Emily Bergin
- 1. Division of Patient-Focused Economic and Policy ResearchGlobal Healthy Living Foundation, Upper Nyack, New York, USA
| | - Jonathan Kay
- Division of Patient-Focused Economic and Policy ResearchGlobal Healthy Living Foundation, Upper Nyack, New York, USA
| | - Erik Stone
- Division of Patient-Focused Economic and Policy ResearchGlobal Healthy Living Foundation, Upper Nyack, New York, USA
| | - Robert Popovian
- Division of Patient-Focused Economic and Policy ResearchGlobal Healthy Living Foundation, Upper Nyack, New York, USA
- Pioneer Institute, Boston, Massachusetts, USA
- Progressive Policy Institute, Washington, DC, USA
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3
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Kay J, Cross RK, Feldman SR, Park Y, Hanauer SB. Review of Adalimumab Biosimilar SB5 in Immune-Mediated Inflammatory Diseases. Adv Ther 2024; 41:509-533. [PMID: 38110655 PMCID: PMC10838831 DOI: 10.1007/s12325-023-02737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023]
Abstract
SB5 is an approved biosimilar of adalimumab, a recombinant monoclonal anti-tumor necrosis factor (TNF) antibody. The approval of SB5 was based on the comparison with reference adalimumab in analytical studies, pharmacokinetic (PK) and immunogenicity assessments, and randomized controlled trials. Efficacy data was primarily obtained in patients with rheumatoid arthritis, and extended to include additional indications such as psoriasis, Crohn's disease, or ulcerative colitis by extrapolation. Following its approval, additional post-marketing data have been collected comparing SB5 with reference adalimumab. This review summarizes the clinical data on SB5 from randomized controlled trials and provides a comprehensive overview of the available post-approval data. In "real-world" settings, SB5 was as effective as its reference product across different indications and countries, treatment persistence was well maintained throughout studies, and no new safety concerns were identified. In both controlled and "real-world" settings, switching from reference adalimumab to SB5 was not associated with altered efficacy or clinical complications. In post-approval studies, the quality of SB5 was consistent over time, independent of the batch and process changes, and the SB5 autoinjector was preferred over other autoinjectors by both healthcare professionals and patients. Taken together, these data support the use of SB5 whenever reference adalimumab is appropriate and demonstrate that switching from reference adalimumab to SB5 is feasible.
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Affiliation(s)
- Jonathan Kay
- Division of Rheumatology, Department of Medicine, UMass Chan Medical School, Worcester, MA, 01605, USA
| | - Raymond K Cross
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, 685 West Baltimore Street, Suite 8-00, Baltimore, MD, 21201, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA
| | | | - Stephen B Hanauer
- Department of Medicine (Gastroenterology and Hepatology), Northwestern University, Chicago, IL, 60611, USA.
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4
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Ruda RC, Kelly KA, Feldman SR. Real-world outcomes following switching from anti-TNF reference products to biosimilars for the treatment of psoriasis. J DERMATOL TREAT 2023; 34:2140569. [PMID: 36305624 DOI: 10.1080/09546634.2022.2140569] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Tumor necrosis factor (TNF) inhibitors improved clinical outcomes for patients with psoriasis but are limited by their high cost. There are several biosimilar options approved for the treatment of psoriasis which provides a lower-cost alternative and the potential to increase treatment availability for both biologically naïve and bioexperienced patients. Numerous phase III randomized controlled trials (RCTs) have investigated the effects of switching from biologics to biosimilars; biosimilars had comparable safety and efficacy to their reference products. Real-world evidence may provide complementary information on the expected performance of biosimilars. In this literature review, we analyzed data from real-world studies on switching from biologics for psoriasis to their biosimilars. Effectiveness and safety profiles were comparable when switching from biologics to biosimilars of adalimumab, etanercept, and infliximab. These studies are limited by their sample sizes, duration of follow-up, and single-arm designs without control groups. Based on available real-world evidence, patients may safely and effectively undergo switching to biosimilar therapies for the treatment of psoriasis.
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Affiliation(s)
- Rachel C Ruda
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Katherine A Kelly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
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5
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Girolomoni G, Savage L, Gisondi P, Svensson Å, Mahé E, Augustin M, Puig L. Increasing Access to Effective Systemic Treatments in Patients with Moderate-to-Severe Psoriasis: Narrative Review. Dermatol Ther (Heidelb) 2023; 13:2171-2185. [PMID: 37710078 PMCID: PMC10539267 DOI: 10.1007/s13555-023-01014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory disease with a worldwide prevalence ranging between 0.51 and 11.43%. It results in a large clinical and social burden, with patients frequently suffering from reduced quality of life, psychologic distress and debilitating comorbidities. Biologic agents are used to establish and maintain disease control in patients with moderate-to-severe psoriasis and are essential to improving quality of life. However, a substantial proportion of patients have limited access to therapy due to economics, health policies and clinical considerations, which creates clinical unmet needs that disadvantage both patients and healthcare professionals. Biosimilars are a cost-effective alternative to off-patent biologic therapies, and there is mounting evidence to suggest they offer a valuable pharmacoeconomic strategy to lower healthcare costs in patients with psoriasis. Furthermore, the introduction of biosimilars can increase the number of patients able to receive biologics, allowing these patients to be treated earlier in the disease course, potentially modifying the course of their disease and reducing the risk of comorbidities. In time, the emergence of additional data, particularly those related to long-term safety, efficacy in extrapolated indications and the effects of switching, should reassure physicians and help overcome the final hurdles for a wider implementation of biosimilars. This review aims to provide an overview of current treatment approaches for patients with moderate-to-severe psoriasis in the biosimilars era and explores both the current challenges and potential opportunities to improve access to high-quality, effective treatments.
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Affiliation(s)
- Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Laura Savage
- Department of Dermatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Åke Svensson
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Emmanuel Mahé
- Department of Dermatology and Venereology, Department of Medicine, Hospital Victor-Dupouy, Argenteuil, France
| | - Matthias Augustin
- University Medical Center Hamburg-Eppendorf, Institute for Health Services Research in Dermatology and Nursing, Hamburg, Germany
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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6
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Phan DB, Jourdain H, González-Quesada A, Zureik M, Rivera-Díaz R, Sahuquillo-Torralba A, Descalzo-Gallego MA, Lunt M, Garcia-Doval I, Sbidian E, Warren RB, Yiu ZZN. Drug survival and safety of biosimilars and originator adalimumab in the treatment of psoriasis: a multinational cohort study. BMJ Open 2023; 13:e075197. [PMID: 37451726 PMCID: PMC10351260 DOI: 10.1136/bmjopen-2023-075197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease. Adalimumab is an effective but previously expensive biological treatment for psoriasis. The introduction of biosimilars following the patent expiry of the originator adalimumab Humira has reduced the unit cost of treatment. However, the long-term effectiveness and safety of adalimumab biosimilars for treating psoriasis in real-world settings are uncertain and may be a barrier to widespread usage. METHODS AND ANALYSIS This study aims to compare the drug survival and safety of adalimumab biosimilars to adalimumab originator for the treatment of psoriasis. We will use both routinely collected healthcare databases and dedicated pharmacovigilance registries from the PsoNet initiative, including data from the UK, France and Spain. We will conduct a cohort study using a prevalent new user design. We will match patients on previous adalimumab exposure time to create two equal-sized cohorts of biosimilar and originator users. The coprimary outcomes are drug survival, defined by the time from cohort entry to discontinuation of the drug of interest; and risk of serious adverse events, defined by adverse events leading to hospitalisation or death. Cox proportional hazards models will be fitted to calculate HRs as the effect estimate for the outcomes. ETHICS AND DISSEMINATION The participating registries agree with the Declaration of Helsinki and received approval from local ethics committees. The results of the study will be published in scientific journals and presented at international dermatology conferences by the end of 2023.
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Grants
- Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene
- Amgen, Arena, Astellas
- UCB
- Pfizer
- Novartis
- Leo
- Janssen, Lilly
- Celgene
- GSK, Janssen, Lilly, Leo, Novartis, Pfizer, Sanofi, Sun Pharma, UCB
- The BAD
- British Association of Dermatologists (BAD)
- University of Manchester
- The British Association of Dermatologists
- Amgen
- NIHR Manchester Biomedical Research Centre
- Psoriasis Association
- BAD
- UCB Pharma
- Sandoz
- Amgen, Celgene, Janssen, LEO Pharma, Lilly, Novartis, Samsung
- AbbVie
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Affiliation(s)
- Duc Binh Phan
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
| | - Hugo Jourdain
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Alicia González-Quesada
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Raquel Rivera-Díaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Mark Lunt
- Versus Arthritis Epidemiology Unit, The University of Manchester, Manchester, UK
| | - Ignacio Garcia-Doval
- , Research Unit, Fundacion Piel Sana AEDV, Madrid, Spain
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Emilie Sbidian
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Est Créteil University, Créteil, France
| | - R B Warren
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
| | - Zenas Z N Yiu
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
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7
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Phan DB, Elyoussfi S, Stevenson M, Lunt M, Warren RB, Yiu ZZN. Biosimilars for the Treatment of Psoriasis: A Systematic Review of Clinical Trials and Observational Studies. JAMA Dermatol 2023; 159:763-771. [PMID: 37256582 DOI: 10.1001/jamadermatol.2023.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Importance Biosimilars have the potential to reduce costs for the management of moderate-to-severe psoriasis compared with originators. However, the extrapolation of evidence enables the approval of a biosimilar for use in indications held by the originator without directly being studied in clinical trials. Thus, biosimilars can be approved for psoriasis based on extrapolated evidence from other diseases. The availability of evidence for the effectiveness and safety of biosimilars for the treatment of psoriasis is therefore unclear. Objective To compare the efficacy/effectiveness and safety of biosimilars with originator biologics for the treatment of patients with psoriasis. Evidence Review MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov, and The European Union Clinical Trials Register were searched in August 2022. Eligible studies were appraised using the Cochrane Risk of Bias 2 and ROBINS-I tools. All analyses were conducted from September 2022 to November 2022. Findings Fourteen trials (10 adalimumab, 2 etanercept, 1 infliximab, and 1 ustekinumab) and 3 cohort studies (1 adalimumab, 1 etanercept, 1 infliximab and etanercept) were included. Twelve trials compared biosimilars with originators in originator-naive patients (starters), and 11 trials compared switching from originator to biosimilar (switchers) with continuous originator treatments. There was no clinically or statistically significant difference in rates of achieving 75% improvement in Psoriasis Area and Severity Index scores and risks of adverse events (AEs) at week 16 and week 52 between the comparators. Two cohort studies showed no difference in effectiveness and safety outcomes between originators and biosimilars, whereas 1 study reported more AEs in patients who switched to biosimilars of adalimumab at 12 months. Three trials showed low risk of bias, whereas 11 trials had moderate risk of bias. All cohort studies had moderate to high risk of bias. Conclusions and Relevance In this systematic review, there was no clinically or statistically significant difference in the efficacy and safety between biosimilars and originators for the treatment of patients with psoriasis. Most of the available evidence was based on randomized clinical trials, although high-quality real-world evidence was lacking. Future studies are needed to examine the long-term effectiveness and safety of biosimilars for the treatment of patients with psoriasis.
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Affiliation(s)
- Duc Binh Phan
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
| | - Sarah Elyoussfi
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
| | - Michael Stevenson
- The University of Manchester Library, The University of Manchester, Manchester, United Kingdom
| | - Mark Lunt
- Versus Arthritis Epidemiology Unit, The University of Manchester, Manchester, United Kingdom
| | - Richard B Warren
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
| | - Zenas Z N Yiu
- Centre for Dermatology Research, Northern Care Alliance NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
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8
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Killion L, Alsharqi A, Kirby B. Switching from adalimumab originator to biosimilar: a 3-year retrospective cohort analysis. Clin Exp Dermatol 2023; 48:397-398. [PMID: 36745550 DOI: 10.1093/ced/llac122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Indexed: 01/09/2023]
Abstract
Our three year retrospective cohort study demonstrated that the vast majority of patients tolerated the switch from adalimumab originator to adalimumab biosimilar, with a 19% switchback rate. All patients who switched back to originator from biosimilar recovered from loss of efficiency and reported adverse events.
Physicians therefore should be confident in switching patients with well controlled psoriasis to adalimumab biosimilars.
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Affiliation(s)
- Lisa Killion
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - Ali Alsharqi
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
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9
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Ruiz-Villaverde R, Velasco-Amador JP, Prados-Carmona A, Ruiz-Carrascosa JC. Switching from reference adalimumab to biosimilar. Assessment of clinical outcomes in psoriasis. Int J Dermatol 2023; 62:e159-e161. [PMID: 35948826 DOI: 10.1111/ijd.16399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Spain Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Juan Pablo Velasco-Amador
- Department of Dermatology, Hospital Universitario San Cecilio, Spain Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Alvaro Prados-Carmona
- Department of Dermatology, Hospital Universitario San Cecilio, Spain Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Jose Carlos Ruiz-Carrascosa
- Department of Dermatology, Hospital Universitario San Cecilio, Spain Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
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10
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Shen J, Liu Y. Real-world evidence of biological agents in dermatology: A review of its applications, advantages, and limitations. Dermatol Ther 2022; 35:e15909. [PMID: 36205394 DOI: 10.1111/dth.15909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
Randomized controlled trials (RCTs) are regarded as the gold standard of evidence-based medicine. However, the disadvantages of RCTs have been well-documented for a lengthy period of time. Due to the carefully controlled conditions, a small group of patients is studied, resulting in a lack of external validity and generalizability. To address this issue, real-world evidence (RWE) has grown in importance as a complement to randomized controlled trials (RCTs). We introduce and describe the databases used by RWE in this post. Applications of RWE are described in following aspects with examples of patients in the use of biological agents with skin diseases: (1) support the safety and efficacy outcomes of RCTs; (2) reveal real-world situations of adverse event management; (3) optimal treatment plans; (4) treatment's real-world cost burden. We also focus on its superiority of generalizability, external validity, and time and economic efficiencies as well as its deficiencies in data resources, study design, and statistical methodologies.
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Affiliation(s)
- Jiaqing Shen
- Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yi Liu
- Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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11
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López‐Ferrer A, Vilarrasa E, Armesto S, Santos‐Juanes J, Galache C, Carretero G, Sahuquillo A, Salgado‐Boquete L, del Alcázar E, González‐Cantero A, Martorell A, Rivera‐Díaz R, Mitxelena‐Ezeiza J, Mateu A, Belinchón I, Llamas‐Velasco M, Riera‐Monroig J, Lázaro A, López‐Estebaranz JL, Gich I, Puig L. Drug survival of adalimumab biosimilars in real world treatment of psoriasis: a Spanish multicenter study. Dermatol Ther 2022; 35:e15831. [DOI: 10.1111/dth.15831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/31/2022] [Accepted: 09/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Anna López‐Ferrer
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Eva Vilarrasa
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Susana Armesto
- Department of Dermatology Hospital Universitario Marqués de Valdecilla Santander Spain
| | - Jorge Santos‐Juanes
- Deparment of Dermatology Hospital Universitario Central de Asturias Oviedo Spain
| | - Cristina Galache
- Deparment of Dermatology Hospital Universitario Central de Asturias Oviedo Spain
| | - Gregorio Carretero
- Department of Dermatology Hospital Universitario de Gran Canaria Doctor Negrin Las Palmas de Gran Canaria Spain
| | - Antonio Sahuquillo
- Department of Dermatology Hospital Universitario y Politécnico La Fe de Valencia Valencia Spain
| | - Laura Salgado‐Boquete
- Department of Dermatology Complexo hospitalario Universitario de Pontevedra Pontevedra Spain
| | - Elena del Alcázar
- Department of Dermatology Hospital Germans Trias i Pujol, Badalona Barcelona Spain
| | | | - Antonio Martorell
- Department of Dermatology Hospital de Manises Manises Valencia Spain
| | | | | | - Almudena Mateu
- Department of Dermatology Hospital Universitario Doctor Peset Valencia Spain
| | - Isabel Belinchón
- Department of Dermatology Hospital General Universitario de Alicante Alicante Spain
| | | | | | - Anna Lázaro
- Department of Dermatology Hospital Universitari Sagrat Cor Barcelona Spain
| | | | - Ignasi Gich
- Department of Epidemiology Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Lluis Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Barcelona Spain
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12
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Patel PV, Purvis CG, Hamid RN, Feldman SR. Non-Medical Switching in Dermatology: Cost-Conscious Policy or an Affront to Patient Safety? J DERMATOL TREAT 2022; 33:2707-2710. [PMID: 35924458 DOI: 10.1080/09546634.2022.2110360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Non-medical switching is when a patient's therapy is switched for reasons unrelated to health outcomes. Dermatologists are regularly affected by non-medical switching, as many of their complex patients are on expensive medications, which become first-line targets for cost-containment. This commentary examines the literature on non-medical switching and explores the push and pull factors used to drive medication regimen changes. The system-level cost savings of this practice are substantial and could be used to fund treatment for more vulnerable patients. While there is no substantiated evidence of worse outcomes post-switching, patients may suffer negative psychosocial consequences. Negative patient expectations, which are in part fueled by prescriber suspicion of non-medical switching, seem to contribute to this effect. While non-medical switching is not ideal for all patients, it has the potential to reduce cost while maintaining patient outcomes. The decision to switch should be made only after careful evaluation of the individual patient and their physical and psychological reserve.
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Affiliation(s)
- Palak V Patel
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Caitlin G Purvis
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ramiz N Hamid
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston- Salem, North Carolina.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
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Schreiber S, Puig L, Gonçalves J, Mease PJ, Panaccione R, Emery P. Critical Appraisal and Future Outlook on Anti-Inflammatory Biosimilar Use in Chronic Immune-Mediated Inflammatory Diseases. Semin Arthritis Rheum 2022; 55:152023. [DOI: 10.1016/j.semarthrit.2022.152023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/15/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
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14
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Switching from Adalimumab Originator to Biosimilar: Clinical Experience in Patients with Hidradenitis Suppurativa. J Clin Med 2022; 11:jcm11041007. [PMID: 35207280 PMCID: PMC8879480 DOI: 10.3390/jcm11041007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 02/07/2023] Open
Abstract
Adalimumab is currently the only biological medicine approved by the FDA for the treatment of hidradenitis suppurativa (HS). The breakout of biosimilar drugs made them more accessible due to their impact on pharmacoeconomics. However, packaging, formulation, or excipients are unique characteristics of each drug. In that way, switching from adalimumab originator to biosimilar and between biosimilars could have implications in the clinical practice. The objective of this study is to describe our clinical experience in switching from adalimumab originator to biosimilar and switching back again. A single-center retrospective cohort study was conducted that included seventeen patients with HS treated with adalimumab originator in the maintenance phase, and that achieved Hidradenitis Suppurativa Clinical Response (HiSCR), who were switched to adalimumab biosimilar for no medical reasons. The reason for the change was to improve pharmacoeconomic efficiency, following our hospital policies on biologics. Median duration with adalimumab originator treatment before switching was 48 weeks. After switching, 41.2% of patients maintained HiSCR response without additional issues, while 58.8% (10/17) reported problems after the change. Switching from adalimumab originator to biosimilar in well-controlled patients could imply problems in efficacy and adherence. Switching back to adalimumab originator appears to solve most of the problems, but some patients can lose confidence in the drug and discontinue it. It would be worthwhile to evaluate the benefit–risk ratio individually when switching an HS patient to adalimumab biosimilar.
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García-Beloso N, Altabás-González I, Samartín-Ucha M, Gayoso-Rey M, De Castro-Parga ML, Salgado-Barreira Á, Cibeira-Badia A, Piñeiro-Corrales MG, González-Vilas D, Pego-Reigosa JM, Martínez-López de Castro N. Switching between reference adalimumab and biosimilars in chronic immune-mediated inflammatory diseases: A systematic literature review. Br J Clin Pharmacol 2021; 88:1529-1550. [PMID: 34622969 DOI: 10.1111/bcp.15101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/30/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
AIMS Adalimumab is a biological therapy used to treat different chronic inflammatory diseases. At present, there is an increasing number of adalimumab biosimilars. To assume the acceptability of interchangeability between reference adalimumab and biosimilars, there should be evidence about efficacy and safety of this switching. Regulation of this practice falls under the authority of individual European Union Member States. The aim of this study is to systematically review the evidence on the efficacy, safety and immunogenicity of switching between reference adalimumab and biosimilars in different chronic immune-mediated inflammatory diseases. METHODS Studies presenting data about switching between reference adalimumab and biosimilars were identified by sensitive search strategies in Medline and EMBASE from 1 January 2004 to 30 June 2021. RESULTS A total of 471 references were obtained and 21 finally included in the analysis (total number of patients switching: 2802). Eight different adalimumab biosimilars were tested after receiving reference adalimumab. Eight articles included rheumatoid arthritis (RA), one miscellaneous rheumatic disease, six psoriasis (PSO) and six inflammatory bowel disease (IBD) patients. Overall, the efficacy results in the switching groups were comparable to those obtained in the arms of continuous biosimilar and continuous reference adalimumab. There were no significant differences in treatment emergent adverse events, anti-drug or neutralising antibodies among the three groups. CONCLUSIONS Switching between reference adalimumab and biosimilars has no impact on efficacy, safety and immunogenicity in patients with RA, PSO and IBD. This finding was consistent for the different adalimumab biosimilars analysed. These conclusions could probably be extended to other rheumatic diseases such as psoriatic arthritis and ankylosing spondylitis.
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Affiliation(s)
| | - Irene Altabás-González
- Department of Rheumatology, University Hospital Complex of Vigo, Vigo, Spain.,IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain
| | - Marisol Samartín-Ucha
- Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.,IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain
| | - Mónica Gayoso-Rey
- Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain
| | | | - Ángel Salgado-Barreira
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur, SERGAS-UVIGO, Vigo, Spain
| | - Amelia Cibeira-Badia
- Department of Scientific Library, University Hospital Complex of Vigo, Vigo, Spain
| | | | | | - Jose María Pego-Reigosa
- Department of Rheumatology, University Hospital Complex of Vigo, Vigo, Spain.,IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain
| | - Noemí Martínez-López de Castro
- Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.,IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases) Group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain
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