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Sequier L, Caron B, Danese S, Peyrin-Biroulet L. Clinical experience of using biosimilars in Crohn's disease and their effectiveness. Expert Opin Biol Ther 2024:1-25. [PMID: 39269146 DOI: 10.1080/14712598.2024.2401616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024]
Abstract
INTRODUCTION The approval of biosimilars in the management of inflammatory bowel diseases (IBDs) has offered an answer to a growing concern about healthcare costs, and availability of treatments. Several studies have been conducted to demonstrate proof of biosimilars effectiveness as treatment in Crohn's disease (CD). AREAS COVERED Since 2013, the European Medicines Agency has approved five biosimilars for infliximab and eight for adalimumab. Initial data leading to approval were extrapolated from studies conducted in patients with rheumatological or dermatological diseases, but recent studies filled the gap of clinical data among patients with IBD. In this review, 75 studies were included, with data from a total of 20 707 patients with CD. Clinical data on biosimilars in the treatment of CD show equivalence in terms of efficacy, either as induction or maintenance of treatment and regardless of previous exposure to originator or other biosimilar. EXPERT OPINION Since biosimilar market entry, utilization of infliximab increased by 89.9% and by 22.4% for adalimumab in European countries. With a 10-year insight since the first approval of biosimilar in Europe, biosimilars prescriptions should be implemented in routine clinical practice given the efficacy and safety profile.
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Affiliation(s)
- Léa Sequier
- Department of Gastroenterology and Hepatology, Nîmes University Hospital, Carémeau Hospital, Nîmes, France
- Department of Gastroenterology and Hepatology A, Saint-Éloi Hospital, Montpellier, France
| | - Bénédicte Caron
- Department of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- INSERM, NGERE, University of Lorraine, Nancy, France
- INFINY Institute, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Silvio Danese
- Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Immunology, Transplantation and Infectious Disease, Università Vita-Salute San Raffaele, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- INSERM, NGERE, University of Lorraine, Nancy, France
- INFINY Institute, Nancy University Hospital, Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, Vandœuvre-lès-Nancy, France
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Zeng Z, Lin H, Jiang M, Yuan J, Li X, Jia Y, Yang L, Zhang H. Anti-TNFα in inflammatory bowel disease: from originators to biosimilars. Front Pharmacol 2024; 15:1424606. [PMID: 39114362 PMCID: PMC11303209 DOI: 10.3389/fphar.2024.1424606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/12/2024] [Indexed: 08/10/2024] Open
Abstract
The introduction of anti-tumor necrosis factor α (TNFα) biologics significantly innovated inflammatory bowel disease (IBD) treatment and increased medical costs. The recent expiration of patents of some anti-TNFα biologics (such as infliximab and adalimumab) facilitated the development of biosimilars. Comparable pharmacokinetic, efficacy, safety, and immunogenicity profiles between anti-TNFα originators and biosimilars were demonstrated in different studies. Anti-TNFα biosimilars hold promise for reducing the high cost of biologics and increasing patient access to biologics. In this review, we outline the current data on the use of anti-TNFα originators and biosimilars in patients with IBD, with a focus on the efficacy, safety, and immunogenicity profiles of infliximab and adalimumab biosimilars. The potential benefits, challenges, and future directions of anti-TNFα biosimilars are also discussed in the review.
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Affiliation(s)
- Zhen Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Centre for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Lin
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Centre for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Mingshan Jiang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Centre for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Centre for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Li
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yongbin Jia
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Li Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Hu Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
- Centre for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Jourdain H, Hoisnard L, Sbidian E, Zureik M. Persistence and safety of anti-TNF biosimilars versus originators in immune-mediated inflammatory diseases: an observational study on the French National Health Data System. RMD Open 2024; 10:e003531. [PMID: 38453213 PMCID: PMC10921511 DOI: 10.1136/rmdopen-2023-003531] [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: 07/24/2023] [Accepted: 01/20/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES Biosimilar-originator equivalence has been demonstrated in phase 3 trials in a few indications of infliximab, etanercept and adalimumab. The objective of our study was to compare the persistence and safety of biosimilars versus originators in all the licensed indications of these molecules. METHODS We used data from the French National Health Data System (SNDS), covering 99% of the French population, to identify infliximab, etanercept and adalimumab initiators from biosimilar launch (January 2015, May 2016 and October 2018, respectively) to 30 June 2021. Patients were then followed for 1 year. Treatment persistence (duration without treatment discontinuation or modification) and safety (including severe infections, all-cause hospitalisation and death) were compared between originator and biosimilar users by Cox regressions weighting the populations on the inverse probability of treatment. Analyses were performed by molecule, by disease and by biosimilar product. RESULTS From January 2015 to June 2021, 86 776 patients were included in the study: 22 670, 24 442 and 39 664 patients had initiated infliximab, etanercept and adalimumab, respectively; 49 752 (53%) were biosimilar initiators. We did not find any risk of discontinuation (HRs were below or around 1, here all pathologies and products together: infliximab 0.88 (0.80-0.97), etanercept 0.85 (0.81-0.90) and adalimumab 0.96 (0.91-1.00)) or safety event (infection: infliximab 0.97 (0.78-1.21), etanercept 1.04 (0.81-1.33) and adalimumab 0.98 (0.83-1.16); hospitalisation: infliximab 1.08 (0.96-1.23), etanercept 0.99 (0.87-1.11) and adalimumab 0.91 (0.83-0.99)) associated with biosimilar versus originator use. CONCLUSIONS Our study shows reassuring results regarding the persistence and safety of biosimilar tumour necrosis factor-alpha inhibitors compared with originators in all licensed indications.
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Affiliation(s)
- Hugo Jourdain
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Léa Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
| | - Emilie Sbidian
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
- Centre d'Investigation Clinique 1430, INSERM, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
- Anti-Infective Evasion and Pharmacoepidemiology, CESP, University Paris-Saclay - UVSQ, Montigny le Bretonneux, France
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Tursi A, Mocci G, Del Gaudio A, Papa A. Clinical use of biologics for Crohn's disease in adults: lessons learned from real-world studies. Expert Opin Biol Ther 2024:1-19. [PMID: 38321868 DOI: 10.1080/14712598.2024.2316180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION The therapeutic armamentarium for managing Crohn's disease (CD) has expanded significantly in recent decades. Several biologics with three different mechanisms of action [anti-tumor necrosis factor (TNF)-α, anti-integrin α4β7, and anti-IL 12/23] are currently available to manage CD. AREA COVERED This narrative review aims to summarize the most significant efficacy and safety data on the use of infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ) and ustekinumab (UST) for the treatment of CD obtained from studies conducted in the real world (RW), compared to the results of randomized clinical trials (RCTs). EXPERT OPINION RW studies reported that biologic agents included in this analysis have higher remission rates and lower adverse event rates than findings from RCTs for treating patients with CD. All biological agents have proven effective and safe in RW studies, even when using biosimilars or switching to subcutaneous administration of the molecules for which they are available. Finally, anti-TNF-α agents, particularly IFX, have a higher rate of adverse events (AEs) than VDZ and UST. Therefore, patients at higher risk of AEs may benefit from other biologics than anti-TNF-α. However, further long-term RW studies are needed to confirm these findings.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Angelo Del Gaudio
- Division of Internal Medicine and Gastroenterology, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Alfredo Papa
- Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
- Division of Internal Medicine and Gastroenterology, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
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Meade S, Squirell E, Hoang TT, Chow J, Rosenfeld G. An Update on Anti-TNF Biosimilar Switching-Real-World Clinical Effectiveness and Safety. J Can Assoc Gastroenterol 2024; 7:30-45. [PMID: 38314175 PMCID: PMC10836972 DOI: 10.1093/jcag/gwad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
Background Biological medications for inflammatory bowel disease (IBD) account for a significant burden on provincial budgets. In an effort to curb these rising costs, nationwide switching to biosimilars is expected to be complete in Canada before the end of 2023. Biosimilar products do not require the same rigor for licensing as the originator and therefore there has been appropriate scepticism as to how biosimilars will perform in real-world practice. Methods We have performed a systematic review including real-world observational studies of adult patients with IBD. The primary outcome was clinical effectiveness and/or safety in patients who had switched from originator to biosimilar anti-TNF. Secondary outcomes included loss of response (LOR), treatment persistence or cessation and immunogenicity. Results We included 43 studies (7,462 patients [70 percent Crohn's disease: 30 percent ulcerative colitis]; 32 infliximab studies, and 11 adalimumab studies). For infliximab, 75 percent patients were in clinical remission at the time of switch and 75 percent maintained clinical remission beyond 12 months, compared to 78 percent of patients who continued originator. For adalimumab, 86 percent patients were in remission at the time of switch with 82 percent maintaining remission at 6 months follow-up. Injection site pain was higher in patients who switched to a citrate containing adalimumab biosimilar, compared with those who continued originator. All other outcomes (LOR, treatment cessation or persistence and serious adverse events) were similar to patients who continued originator (in comparator cohorts or the available literature). Conclusion Whilst ongoing vigilance is required, these data are reassuring to both patients and clinicians and will significantly help to reduce health-care costs across Canada.
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Affiliation(s)
- Susanna Meade
- University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | | | | | - James Chow
- BioPro Biologics Pharmacy, 845 West Broadway, Vancouver, BC V5Z1J9, Canada
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Fernández-Cano MC, Fernández-Cano AJ, Martín-Rodríguez MM, Sánchez-Capilla AD, Cabello-Tapia MJ, Redondo-Cerezo E. Adalimumab Persistence and Its Biosimilar in Inflammatory Bowel Disease: A Real-World Study. J Clin Med 2024; 13:556. [PMID: 38256689 PMCID: PMC10816059 DOI: 10.3390/jcm13020556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Adalimumab biosimilar experience is still recent. Interchangeability differences could reduce persistence times. Our goal was to compare biosimilar persistence differences with a reference. A retrospective observational study was performed in three groups divided according to the adalimumab received. The primary outcome measure was persistence, represented with Kaplan-Meier analysis, and we secondarily evaluated security, efficacy, and biomarkers. We obtained approval from the regional ethical committee, and the study was conducted following the Helsinki Declaration as revised in 2013. Data from 104 patients were collected: 50 received the biosimilar, 29 received the reference, and 25 switched from the original to the biosimilar. After a follow-up of 12 months, the biosimilar's persistence was higher, without differences in mild adverse events per group. In contrast, there were differences in severe events, with the switched group's frequency being higher. Biomarkers were reduced at similar proportions in all groups, and 43% had a clinical response at week 20 without differences. Adalimumab biosimilars are a valuable option for IBD based on clinical equivalence that are less expensive than the original drug. Their use does not have a detrimental influence on disease, although there are a few nuances in terms of interchangeability. These results support increasing confidence in using biosimilars, thus promoting the better sustainability of health systems.
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Affiliation(s)
- María Carmen Fernández-Cano
- Gastroenterology and Hepatology Unit, Virgen de las Nieves University Hospital, 18014 Granada, Spain
- Doctoral Programme in Clinical Medicine and Public Health, Faculty of Medicine, University of Granada, 18012 Granada, Spain
| | - Antonio Jesús Fernández-Cano
- Citizen Innovation Department, Consortium for Developing the Information and Knowledge Society in Andalusia “Fernando de los Ríos”, 18016 Granada, Spain
| | | | | | - María José Cabello-Tapia
- Gastroenterology and Hepatology Unit, Virgen de las Nieves University Hospital, 18014 Granada, Spain
| | - Eduardo Redondo-Cerezo
- Gastroenterology and Hepatology Unit, Virgen de las Nieves University Hospital, 18014 Granada, Spain
- Doctoral Programme in Clinical Medicine and Public Health, Faculty of Medicine, University of Granada, 18012 Granada, Spain
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Jin R, Kruppert S, Scholz F, Bardoulat I, Karzazi K, Kricorian G, O’Kelly JL, Reinisch W. Treatment persistence and switching patterns of ABP 501 in European patients with inflammatory bowel disease. Therap Adv Gastroenterol 2024; 17:17562848231222332. [PMID: 38221908 PMCID: PMC10787526 DOI: 10.1177/17562848231222332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024] Open
Abstract
Background Approval of the adalimumab (ADA) biosimilar ABP 501 for inflammatory bowel disease (IBD) indications was based on the principle of extrapolation, without indication-specific clinical trial data. Objectives To evaluate the real-world treatment patterns of ABP 501 in patients with IBD. Design Retrospective analysis of pharmacy claims data from Germany and France. Methods Continuously insured adult IBD patients who initiated ABP 501 between October 2018 and March 2020 were included. Treatment persistence, adherence, and post-ABP 501 switching patterns were evaluated for two mutually exclusive groups: ADA-naïve patients (i.e. no baseline use of ADA products) and ADA-experienced patients (i.e. previously treated with ADA products). Results A total of 3362 German patients and 733 French patients were included, with 54.4% and 65.3% being ADA-naïve patients, respectively. Median persistence (95% CI) on ABP 501 was 10.9 months (9.8-11.6) in ADA-naïve patients and 14.2 months (12.7-15.2) in ADA-experienced patients in Germany; for the French cohort, ADA-naïve and -experienced patients had median persistence of 12.8 months (10.2-14.7) and 11.5 months (8.8-14.4), respectively. During the first 12 months of ABP 501 initiation, 53.7% of German patients and 51.0% of French patients were adherent to the therapy. About 20% of patients in both countries switched from ABP 501 to another targeted therapy. In the German cohort, ADA-naïve patients most frequently switched to non-tumor necrosis factor inhibitor biologics, but ADA-experienced patients most commonly switched to reference product (RP); in the French cohort, patients most often switched to RP regardless of prior exposure to ADA products. Conclusion About 50% of patients persisted on and were adherent to ABP 501 therapy during the first 12 months after treatment initiation in two large European countries. Post-ABP 501, switching patterns varied between countries, indicating diversified treatment practices warranting further research on reason(s) for switching and potential overall treatment outcomes.
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Affiliation(s)
- Ran Jin
- Amgen Inc., 1 Amgen Center Dr, Thousand Oaks, CA 91320, USA
| | | | | | | | | | | | | | - Walter Reinisch
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Jin R, Nduka C, Courmier D, Knight H, Meadows R, Piercy J, Cummings JRF, Radziszewski W. Real-World Experience of Adalimumab Biosimilar (ABP 501) Use in Patients with Inflammatory Bowel Disease in Europe. Adv Ther 2024; 41:331-348. [PMID: 37957522 PMCID: PMC10796661 DOI: 10.1007/s12325-023-02712-w] [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: 08/02/2023] [Accepted: 10/11/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Approval of adalimumab biosimilar ABP 501 (Amgevita®) for inflammatory bowel disease (IBD) was based upon the principle of extrapolation. Real-world experience of ABP 501 utilization in IBD can provide useful information to healthcare providers and patients. METHODS Data were drawn from the 2020-2021 Adelphi IBD Disease Specific Programme™ conducted in five major European countries. Participating gastroenterologists completed a point-in-time survey to provide patient medical record data, and patients voluntarily completed questionnaires to report health-related quality of life (HRQoL). Descriptive analyses were conducted for "ABP 501 initiators" (received ABP 501 as first advanced therapy) and "RP-ABP 501 switchers" (switched to ABP 501 from reference product [RP; Humira®] as first advanced therapy). RESULTS This analysis included 239 ABP 501 initiators and 136 RP-ABP 501 switchers. At consultation, initiators had been on ABP 501 treatment for a median of 7.5 months and switchers had received ABP 501 for a median of 7.7 months following the switch from a median of 14.0 months treatment with RP. About 74% of initiators and 89% of switchers were reported by their treating physicians as being in clinical remission. Physicians and patients reported satisfaction with ABP 501 in the range of 92-99% across both groups. Patient self-assessment, including EuroQol visual analogue scale, Short IBD Questionnaire, and Work Productivity and Activity Impairment scores, suggested minimal impairment of HRQoL while on ABP 501. The most common reason for RP to ABP 501 switch was lower healthcare costs. CONCLUSION Both patients with IBD and treating physicians reported high levels of satisfaction with ABP 501 among initiators and switchers.
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Affiliation(s)
- Ran Jin
- Amgen Inc., Thousand Oaks, CA, USA.
| | | | | | - Hannah Knight
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, Cheshire, UK.
| | - Rachael Meadows
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, Cheshire, UK
| | - James Piercy
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Macclesfield, SK10 5JB, Cheshire, UK
| | - J R F Cummings
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Tursi A, Mocci G, Allegretta L, Aragona G, Bianco MA, Colucci R, Cuomo A, Della Valle N, Ferronato A, Forti G, Gaiani F, Giorgetti G, Graziani MG, Lofano K, Lorenzetti R, Larussa T, Penna A, Pica R, Pranzo G, Rodino' S, Scarcelli A, Zampaletta C, Bassotti G, Cazzato AI, Chiri S, Clemente V, Cocco A, De' Angelis G, Donnarumma L, Faggiani R, Graziosi C, Le Grazie M, Luzza F, Meucci C, Monterubbianesi R, Pagnini C, Perazzo P, Picchio M, Sacco R, Sebkova L, Serio M, Napolitano D, Pugliese D, Scaldaferri F, Schiavoni E, Turchini L, Armuzzi A, Elisei W, Maconi G, Papa A. Comparison of Performances of Adalimumab Biosimilars SB5, ABP501, GP2017, and MSB11022 in Treating Patients with Inflammatory Bowel Diseases: A Real-Life, Multicenter, Observational Study. Inflamm Bowel Dis 2023; 29:376-383. [PMID: 35579320 DOI: 10.1093/ibd/izac092] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Adalimumab (ADA) biosimilars have entered the therapeutic armamentarium of inflammatory bowel disease (IBD), allowing for the treatment of a greater number of patients for their reduced cost than the originator. However, comparative data on the efficacy and safety of the various ADA biosimilars remains scarce.We compare the efficacy and safety of ADA biosimilars SB5, ABP501, GP2017, and MSB11022 in treating IBD outpatients in a real-life Italian setting. METHODS A retrospective analysis was performed on consecutive IBD outpatients with complete clinical, laboratory, and endoscopic data. Clinical activity was measured using the Mayo score in ulcerative colitis (UC) and the Harvey-Bradshaw Index in Crohn's disease (CD). The primary endpoints were the following: (1) induction of remission in patients new to biologics and patients new to ADA but previously exposed to other anti-tumor necrosis factor agents or other biologics; (2) maintenance of remission in patients switched from the ADA originator to an ADA biosimilar; and (3) safety of various biosimilars. RESULTS A total of 533 patients were enrolled according to the inclusion criteria: 162 patients with UC and 371 patients with CD. Clinical remission was obtained in 79.6% of patients new to biologics and 59.2% of patients new to ADA but not to other biologics; clinical remission was maintained in 81.0% of patients switched from the originator, and adverse events were recorded in 6.7% of patients. There was no significant difference between the 4 ADA biosimilars for each predetermined endpoint. CONCLUSIONS Adalimumab biosimilars are effective and safe in IBD treatment, both in new patients and in patients switched from the ADA originator. No difference in efficacy and safety was found between ADA biosimilars.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Post-graduate School of Digestive Diseases, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Nicola Della Valle
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - GianMarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | | | - Katia Lofano
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | | | | | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | | | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Camilla Graziosi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Laura Turchini
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | | | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
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Na SY, Choi CH, Song EM, Bang KB, Park SH, Kim ES, Park JJ, Keum B, Lee CK, Lee BI, Ryoo SB, Koh SJ, Choi M, Kim JS. Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis. Intest Res 2023; 21:61-87. [PMID: 35645321 PMCID: PMC9911265 DOI: 10.5217/ir.2022.00007] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/07/2022] [Indexed: 02/09/2023] Open
Abstract
Ulcerative colitis (UC), a relapsing-remitting chronic inflammatory bowel disease (IBD), has a variable natural course but potentially severe disease course. Since the development of anti-tumor necrosis factor (TNF) agents has changed the natural disease course of moderate-to-severe UC, therapeutic options for patients who failed conventional treatments are expanding rapidly. IBD clinical trials have demonstrated the potential efficacy and safety of novel biologics such as anti-integrin α4β7 and anti-interleukin-12/23 monoclonal antibodies and small molecules such as a Janus kinase inhibitor. Anti-TNF biosimilars also have been approved and are widely used in IBD patients. Wise drug choices should be made considering evidence-based efficacy and safety. However, the best position of these drugs remains several questions, with limited data from direct comparative trials. In addition, there are still concerns to be elucidated on the effect of therapeutic drug monitoring and combination therapy with immunomodulators. The appropriate treatment regimens in acute severe UC and the risk of perioperative use of biologics are unclear. As novel biologics and small molecules have been approved in Korea, we present the Korean guidelines for medical management of adult outpatients with moderate-to-severe UC and adult hospitalized patients with acute severe UC, focusing on biologics and small molecules.
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Affiliation(s)
- Soo-Young Na
- Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea,Correspondence to Chang Hwan Choi, Department of Internal Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea. Tel: +82-2-6299-1418, Fax: +82-2-6299-2064, E-mail:
| | - Eun Mi Song
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ki Bae Bang
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology and Inflammatory Bowel Disease Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Soo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Jun Park
- Department of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Bora Keum
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chang Kyun Lee
- Department of Gastroenterology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Bo-In Lee
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Bum Ryoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seong-Joon Koh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Non-medical switch from the originator to biosimilar and between biosimilars of adalimumab in inflammatory bowel disease - a prospective, multicentre study. Dig Liver Dis 2022; 54:1639-1645. [PMID: 35931624 DOI: 10.1016/j.dld.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Clinical data on the efficacy and safety of non-medical switch between adalimumab(ADA) biosimilars are limited. AIMS The aim of this study was to evaluate medium-term clinical efficacy, drug sustainability and safety comparing non-medical switches from the originator to biosimilar ADA, and between ADA biosimilars. METHODS 276 consecutive patients on maintenance ADA therapy (n = 205 Crohn's disease, n = 71 ulcerative colitis) were included. Data on clinical efficacy, biomarkers and adverse events were collected at four time points: 8-12 weeks prior switch, at baseline/switch, 8-12 weeks and 20-24 weeks after switch. Drug survival was evaluated after a median 40(IQR:35-42) weeks follow-up. RESULTS A total 174 patients underwent a non-medical switch from the originator to a biosimilar, and 102 patients had a biosimilar-to-biosimilar switch. No significant difference was found in clinical remission rates at any time point in patients switching from originator to biosimilar(87.3%/88.5%/86.5%/85.7%) or biosimilar to biosimilar(74.5%/78.4%/85.3%/79.8%). Mean C-reactive protein levels remained unchanged in both cohorts(p = 0.856 and p = 0.525). Drug survival was similar between the two cohorts with a probability of 91.6%(SE: 2.2) and 87.0%(SE:3.4) to stay on drug after 40 weeks(log-rank:0.96; p = 0.327). Five cases of injection related adverse events were reported. CONCLUSION Clinical benefit was sustained following non-medical switch from originator to biosimilar, or between biosimilars in adalimumab treated IBD patients.
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Aslam N, Lo SW, Sikafi R, Barnes T, Segal J, Smith PJ, Limdi JK. A review of the therapeutic management of ulcerative colitis. Therap Adv Gastroenterol 2022; 15:17562848221138160. [PMID: 36478780 PMCID: PMC9720837 DOI: 10.1177/17562848221138160] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/26/2022] [Indexed: 12/03/2022] Open
Abstract
Ulcerative colitis (UC) is a chronic relapsing and remitting gastrointestinal disorder of uncertain aetiology. The last two decades have seen an expansion in the therapeutic arsenal used to treat UC. This has resulted in improved clinical remission and response rates. Nonetheless, staples in our current medical management originate from trials conducted in the early 20th century. In this review article, we aim to outline the key milestones in the history of the medical management of UC in addition to highlighting promising therapeutic developments for the future.
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Affiliation(s)
| | | | - Rafid Sikafi
- St Mark’s Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Tom Barnes
- Section of IBD – Division of Gastroenterology, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Jonathan Segal
- Northern Hospital, Epping, Melbourne, VIC, Australia,Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | - Philip J Smith
- Department of Gastroenterology, Royal Liverpool Hospital, Liverpool University Hospitals Foundation NHS Trust, Liverpool, UK
| | - Jimmy K Limdi
- Section of IBD – Division of Gastroenterology, Northern Care Alliance NHS Foundation Trust, Manchester, UK,Manchester Academic Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Larid G, Baudens G, Dandurand A, Coquerelle P, Goeb V, Guyot MH, Marguerie L, Maury F, Veillard E, Houvenagel E, Salmon JH, Flipo RM, Gervais E. Differential retention of adalimumab and etanercept biosimilars compared to originator treatments: Results of a retrospective French multicenter study. Front Med (Lausanne) 2022; 9:989514. [PMID: 36275803 PMCID: PMC9582272 DOI: 10.3389/fmed.2022.989514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Previous studies demonstrated equivalence in terms of efficacy and safety of biosimilars (bsDMARDs) compared to original treatments (boDMARDs) and in switching situations. Less is known about what happens when initiating a bsDMARD in a molecule naïve patient. The objectives of our study were to compare the retention of treatment of subcutaneous boDMARDs and bsDMARDs globally, depending on the disease [rheumatoid arthritis (RA), spondyloarthritis (SpA), or psoriatic arthritis (PsA)], molecule [etanercept (ETN) or adalimumab (ADA)], line of treatment, or presence of citrate in the context of first use of each molecule (namely initiation) and to analyze treatment retention's predictive factors. Materials and methods This multicenter retrospective study used data from shared medical records of the RIC-FRANCE network, encompassing the prescription of hospital rheumatologists and attached practitioners, of patients with RA, SpA, or PsA, with the starting ETN between 03/10/2016 and 31/07/2020, or ADA between 23/10/2018 and 31/07/2020. Clinical data were collected from medical records. Retention analysis was performed using Kaplan-Meier curves and the log-rank test. Retention's predictive factors were analyzed using Cox proportional-hazard ratio. Results Eight hundred forty-five prescriptions were analyzed: 340 boDMARDs and 505 bsDMARDs. About 57% of prescriptions concerned women. The mean age was 51.8 years. About 38% were prescriptions for RA, 16% for PsA, and 46% for SpA. An increase in the initiation over time was observed for both ETN and ADA. The retention rate of bsDMARDs was superior to boDMARDs' one (39 vs. 23 months; p = 0.045). When molecules are compared, the difference was significant only for ETN (45 vs. 19 months for boDMARD; p = 0.0265). When comparing diseases, the difference in favor of bsDMARDs was significant in patients with RA only (p = 0.041). Citrated treatments displayed better retention compared to citrate-free treatments (p = 0.0137). Multivariable analysis of predictive factors for the cessation of treatment found shorter disease duration, boDMARD prescription, hospital practitioner prescription, late line of treatment, and female sex as significant. More side effects were observed with boDMARDs, especially more infections (17.8% vs. 7.8%). Conclusion Even if bsDMARDs' prescription increases over time, its penetration rate is still below expectations. bsDMARDs displayed better retention compared to boDMARDs, especially for ETN, and in patients with RA. Citrated treatments had better retention. Prescription by a full-time hospital-based rheumatologist is associated with poorer retention.
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Affiliation(s)
- Guillaume Larid
- Department of Rheumatology, CHU Poitiers, Poitiers, France,LITEC Laboratory, University of Poitiers, Poitiers, France,*Correspondence: Guillaume Larid, ; orcid.org/0000-0003-2317-2852
| | | | | | - Pascal Coquerelle
- Department of Rheumatology, Bethune Hospital Center, Bethune, France
| | - Vincent Goeb
- Department of Rheumatology, Hôpital Nord, University Hospital of Amiens-Picardie, Amiens, France
| | - Marie Hélène Guyot
- Department of Rheumatology, Hôpital Victor Provo, Hospital of Roubaix, Roubaix, France
| | - Laurent Marguerie
- Department of Rheumatology, Institut François Calot, Berck-Sur-Mer, France
| | | | | | - Eric Houvenagel
- Department of Rheumatology, Hôpital Saint Philibert, Hospital of Lomme, Lomme, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Hôpital Maison Blanche, Reims University Hospital, CEDEX, Reims, France
| | | | - Elisabeth Gervais
- Department of Rheumatology, CHU Poitiers, Poitiers, France,LITEC Laboratory, University of Poitiers, Poitiers, France
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Allocati E, Godman B, Gobbi M, Garattini S, Banzi R. Switching Among Biosimilars: A Review of Clinical Evidence. Front Pharmacol 2022; 13:917814. [PMID: 36091837 PMCID: PMC9449694 DOI: 10.3389/fphar.2022.917814] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022] Open
Abstract
Biological medicines have improved patients' outcomes, but their high costs may limit access. Biosimilars, alternatives that have demonstrated high similarity in terms of quality, safety, and efficacy to an already licensed originator biological product, could increase competition and decrease prices. Given the expanding number of biosimilars, patients may switch from originator to biosimilar or among biosimilars. Randomized trials and observational studies conducted with multiple biosimilars over many disease areas confirmed the safety and efficacy of switching from originator to biosimilar. This study summarizes evidence on switching between biosimilars for which there are concerns to provide future guidance. A systematic search (MEDLINE, Embase, and Cochrane Library) for studies on anti-TNF agents, assessing clinical efficacy and safety of biosimilar-to-biosimilar switch in chronic inflammatory diseases, was performed. We retrieved 320 records and included 19 clinical studies. One study with historical control compared switching between biosimilars to maintenance of the same biosimilar. Ten were controlled cohort studies comparing switching between two biosimilars vs. switching from originator to a biosimilar or vs. multiple switches. Eight were single-arm cohort studies, where participants switched from one biosimilar to another, and the outcomes were compared before and after the switch. Overall, these studies did not highlight significant concerns in switching between biosimilars. Therefore, switching studies seem difficult to perform and unnecessary with the body of evidence suggesting no real problems in practice coupled with stringent regulatory requirements. Monitoring the use of biosimilars in clinical practice could support clinical decision-making, rational use of biological medicines, and help to further realize possible savings.
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Affiliation(s)
- Eleonora Allocati
- Center for Health Regulatory Policies, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Marco Gobbi
- Laboratory of Pharmacodynamics and Pharmacokinetics, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Silvio Garattini
- Presidency, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Rita Banzi
- Center for Health Regulatory Policies, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
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15
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Petric Z, Goncalves J, Paixao P. Under the Umbrella of Clinical Pharmacology: Inflammatory Bowel Disease, Infliximab and Adalimumab, and a Bridge to an Era of Biosimilars. Pharmaceutics 2022; 14:1766. [PMID: 36145514 PMCID: PMC9505802 DOI: 10.3390/pharmaceutics14091766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Monoclonal antibodies (MAbs) have revolutionized the treatment of many chronic inflammatory diseases, including inflammatory bowel disease (IBD). IBD is a term that comprises two quite similar, yet distinctive, disorders-Crohn's disease (CD) and ulcerative colitis (UC). Two blockbuster MAbs, infliximab (IFX) and adalimumab (ADL), transformed the pharmacological approach of treating CD and UC. However, due to the complex interplay of pharmacology and immunology, MAbs face challenges related to their immunogenicity, effectiveness, and safety. To ease the burden of IBD and other severe diseases, biosimilars have emerged as a cost-effective alternative to an originator product. According to the current knowledge, biosimilars of IFX and ADL in IBD patients are shown to be as safe and effective as their originators. The future of biosimilars, in general, is promising due to the potential of making the health care system more sustainable. However, their use is accompanied by misconceptions regarding their effectiveness and safety, as well as by controversy regarding their interchangeability. Hence, until a scientific consensus is achieved, scientific data on the long-term effectiveness and safety of biosimilars are needed.
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Affiliation(s)
- Zvonimir Petric
- Department of Pharmacological Sciences, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-004 Lisboa, Portugal
| | - Joao Goncalves
- Biopharmaceutical and Molecular Biotechnology Unit, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-004 Lisboa, Portugal
| | - Paulo Paixao
- Department of Pharmacological Sciences, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-004 Lisboa, Portugal
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Adalimumab Biosimilar GP2017 versus Adalimumab Originator in Treating Patients with Inflammatory Bowel Diseases: A Real-Life, Multicenter, Observational Study. Biomedicines 2022; 10:biomedicines10081799. [PMID: 35892698 PMCID: PMC9331541 DOI: 10.3390/biomedicines10081799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
The approval of adalimumab (ADA) biosimilars for inflammatory bowel disease (IBD) has reduced the cost of treatment. While several ADA biosimilars are currently available, comparative data on the ADA biosimilar GP2017 (HyrimozTM) and its originator (HumiraTM) in IBD are lacking. We compared the efficacy and safety of GP2017 versus originator in IBD outpatients in an Italian real-life setting. This retrospective analysis enrolled consecutive IBD patients with complete clinical, laboratory, and endoscopic data. Clinical activity was assessed with the Mayo score in ulcerative colitis (UC) and the Harvey–Bradshaw Index in Crohn’s disease (CD). The primary endpoints were the induction of remission and the safety of GP2017 versus ADA originator. One hundred and thirty-four patients (30.6% with UC and 69.4% with CD, median age 38 years) were enrolled: 62 (46.3%) patients were treated with GP2017, and 72 (53.7%) with ADA originator; 118 (88.1%) patients were naïve to ADA. Clinical remission was obtained in 105 (78.4%) patients, during a median follow-up of 12 months, 82.3% and 75% in the GP2017 and ADA originator groups, respectively (p = 0.311). Treatment was well tolerated in both groups. This analysis of real-world data suggests that GP2017 and its originator are equivalent in terms of efficacy and safety in patients with IBD.
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17
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Wu Q, Zhu P, Liu X, Ji Q, Qian M. Nirvana: A Qualitative Study of Posttraumatic Growth in Adolescents and Young Adults with Inflammatory Bowel Disease. CHILDREN (BASEL, SWITZERLAND) 2022; 9:879. [PMID: 35740816 PMCID: PMC9222066 DOI: 10.3390/children9060879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: Psychosomatic discomfort is prevalent among adolescents and young adults (AYAs) with inflammatory bowel disease (IBD). Post-traumatic growth (PTG) has been a protective factor in earlier research. However, little is known regarding PTG among AYAs with IBD. This study investigates the generation of PTG in adolescents and young adults with inflammatory bowel disease (IBD) and finds positive coping skills employed in clinical nursing practice. (2) Methods: In 2021, 32 individuals were interviewed utilizing a semi-structured interview guide. This study used qualitative content analysis. (3) Results: The interviews revealed five themes: spiritual change, internalized supportiveness, cognitive re-shaping, externalized behaviors, and future-oriented thinking. (4) Conclusions: The research revealed the presence of PTG in AYAs with IBD. To give tailored care to patients, medical professionals must monitor the state of their PTG development in a planned and focused manner.
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Affiliation(s)
- Qiwei Wu
- School of Nursing, Yangzhou University, Yangzhou 225009, China; (Q.W.); (X.L.); (Q.J.); (M.Q.)
| | - Pingting Zhu
- School of Nursing, Yangzhou University, Yangzhou 225009, China; (Q.W.); (X.L.); (Q.J.); (M.Q.)
- Jiangsu Key Laboratory of Zoonosis, Yangzhou 225009, China
| | - Xinyi Liu
- School of Nursing, Yangzhou University, Yangzhou 225009, China; (Q.W.); (X.L.); (Q.J.); (M.Q.)
| | - Qiaoying Ji
- School of Nursing, Yangzhou University, Yangzhou 225009, China; (Q.W.); (X.L.); (Q.J.); (M.Q.)
| | - Meiyan Qian
- School of Nursing, Yangzhou University, Yangzhou 225009, China; (Q.W.); (X.L.); (Q.J.); (M.Q.)
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18
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Najeeb H, Yasmin F, Surani S. Emerging role of biosimilars in the clinical care of inflammatory bowel disease patients. World J Clin Cases 2022; 10:4327-4333. [PMID: 35663066 PMCID: PMC9125297 DOI: 10.12998/wjcc.v10.i14.4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/20/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
The increasing incidence of inflammatory bowel disease (IBD) globally has redirected the healthcare system's focus towards safe and affordable pharmacological interventions. The inception of anti-tumor necrosis factor-α (TNF-α) had resulted in a trend shift from surgical interventions. However, as the patents of approved anti-TNF-α drugs expire, biological copies of the many approved products are in the pipeline. The most commonly used biosimilar for IBD has been infliximab, followed by Adalimumab biosimilars which have been approved in major countries across the world. Although biosimilars are approved on the basis of similarity of their reference product, the lack of real-world evidence of its safety in ulcerative colitis and Crohn’s disease patients has contributed to physicians’ hesitancy. However, biosimilars are expected to reduce treatment costs and provide economic benefits.
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Affiliation(s)
- Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Farah Yasmin
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Salim Surani
- Department of Medicine, Texas A&M University, College Station, TX 77843, United States
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
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Adalimumab and ABP 501 in the Treatment of a Large Cohort of Patients with Inflammatory Arthritis: A Real Life Retrospective Analysis. J Pers Med 2022; 12:jpm12030335. [PMID: 35330335 PMCID: PMC8949392 DOI: 10.3390/jpm12030335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
Abstract
The recent introduction of ABP 501, an adalimumab biosimilar, in the treatment of rheumatic diseases was supported by a comprehensive comparability exercise with its originator. On the other hand, observational studies comparing adalimumab and ABP 501 in inflammatory arthritis are still lacking. The main aim of this study is to compare the clinical outcomes of the treatment with adalimumab, both the originator and ABP 501, in a large cohort of patients affected by autoimmune arthritis in a real life setting. We retrospectively analysed the baseline characteristics and the retention rate in a cohort of patients who received at least a course of adalimumab (originator or ABP 501) from January 2003 to December 2020. We stratified the study population according to adalimumab use: naive to original (oADA), naive to ABP 501 (bADA) and switched from original to ABP 501 (sADA). The oADA, bADA and sADA groups included, respectively, 724, 129 and 193 patients. In each group, the majority of patients had a diagnosis of rheumatoid arthritis. The total observation period was 9805.6 patient-months. The 18-month retentions rate in oADA, bADA and sADA was, respectively, 81.5%, 84.0% and 88.0% (p > 0.05). The factors influencing the adalimumab retention rate were an axial spondylarthritis diagnosis (Hazard Ratio (HR) 0.70; p = 0.04), switch from oADA to ABP 501 (HR 0.53; p = 0.02) and year of prescription (HR 1.04; p = 0.04). In this retrospective study, patients naive to the adalimumab originator and its biosimilar ABP 501 showed the same retention rate. Patients switching from the originator to biosimilar had a higher retention rate, even though not statistically significant, when compared to naive.
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Gisbert JP, Gaffney K, Young D, Ebbers HC, Girolomoni G. Current evidence on the use of the adalimumab biosimilar SB5 (Imraldi TM): a multidisciplinary perspective. Expert Opin Biol Ther 2021; 22:109-121. [PMID: 34918591 DOI: 10.1080/14712598.2022.2012146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This review provides an overview of data from trials and real-world studies available for SB5 (ImraldiTM) across three main therapeutic areas: rheumatology, gastroenterology, and dermatology. AREAS COVERED A literature search for publications on data for SB5 efficacy/effectiveness, safety, and immunogenicity was undertaken. EXPERT OPINION Evidence derived from clinical studies suggest that the biosimilar SB5 is a safe and effective alternative to reference adalimumab. Considering that patients suffering from immune-mediated inflammatory diseases such as inflammatory arthritis, inflammatory bowel disease and psoriasis often require long-term biologic treatment, biosimilar medicines (such as SB5) can reduce healthcare costs while increasing access to effective treatments.
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Affiliation(s)
- Javier P Gisbert
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Karl Gaffney
- Rheumatology Department, Norfolk and Norwich Hospitals NHS Foundation Trust, Norwich, UK
| | - David Young
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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21
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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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22
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Ribaldone DG, Tribocco E, Rosso C, Armandi A, Vernero M, Bugianesi E, Astegiano M, Saracco GM, Caviglia GP. Switching from Biosimilar to Biosimilar Adalimumab, Including Multiple Switching, in Crohn's Disease: A Prospective Study. J Clin Med 2021; 10:jcm10153387. [PMID: 34362184 PMCID: PMC8348781 DOI: 10.3390/jcm10153387] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022] Open
Abstract
No data are available regarding the safety and effectiveness of the biosimilar-to-biosimilar switch of adalimumab in any disease, and in particular in Crohn’s disease (CD). The aim of our study was to provide real world data on switching from biosimilar adalimumab to another biosimilar, including multiple switching. We conducted a prospective, single-centre observational study in which we consecutively recruited all CD patients who switched from adalimumab biosimilar ABP 501 to biosimilar SB5 from January to July 2021. Sixty-one patients were included in the final analysis, of whom 43/61 (70.5%) were multiple switches (Humira® → ABP 501 → SB5). After 6 months of follow up, 88.5% (54/61) of patients maintained SB5 on therapy. The success of the switch (defined as no systemic corticosteroids within 6 months, non-discontinuation of SB5, no dose escalation) was achieved by 82.0% (50/61) of patients. At multivariate analysis, C-reactive protein > 5 mg/L predicted switch failure (p = 0.03). Seven patients (11.5%) experienced side effects, compared to one patient (1.6%) in the 6 pre-switch months (p = 0.03). In conclusion, switching from biosimilar to biosimilar of adalimumab did not lead to signs of safety or loss of efficacy other than those already known in the literature for the class of drugs.
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Affiliation(s)
- Davide Giuseppe Ribaldone
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
- Correspondence: (D.G.R.); (C.R.); Tel.: +39-011-6333918 (D.G.R. & C.R.)
| | - Elisa Tribocco
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
| | - Chiara Rosso
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
- Correspondence: (D.G.R.); (C.R.); Tel.: +39-011-6333918 (D.G.R. & C.R.)
| | - Angelo Armandi
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
| | - Marta Vernero
- Department of Internal Medicine, San Matteo Hospital, 27100 Pavia, Italy;
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
| | - Marco Astegiano
- Department of General and Specialist Medicine, Gastroenterologia-U, Città della Salute e della Scienza di Torino, C.so Bramante 88, 10126 Turin, Italy;
| | - Giorgio Maria Saracco
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
| | - Gian Paolo Caviglia
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, 10126 Torino, Italy; (E.T.); (A.A.); (E.B.); (G.M.S.); (G.P.C.)
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23
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Barberio B, Cingolani L, Canova C, Barbieri G, Sablich R, Urbano MT, Bertani L, Costa F, Bodini G, Demarzo MG, Ferronato A, Buda A, Melatti P, Massimi D, Savarino EV, Zingone F. A propensity score-weighted comparison between adalimumab originator and its biosimilars, ABP501 and SB5, in inflammatory bowel disease: a multicenter Italian study. Therap Adv Gastroenterol 2021; 14:17562848211031420. [PMID: 34349836 PMCID: PMC8295962 DOI: 10.1177/17562848211031420] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/22/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Adalimumab is an effective and safe biological drug for the treatment of inflammatory bowel disease (IBD). Nowadays, several biosimilar agents are available, but data regarding their efficacy and safety in patients with IBD are still lacking. We aimed to compare the effectiveness and tolerability between adalimumab originator, ABP501 and SB5 biosimilars in patients with IBD in the short term (after induction and after 6 months of treatment) through a propensity score-weighted multicenter cohort study. METHODS We included 156 patients with IBD, 69 patients with ulcerative colitis and 87 patients with Crohn's disease (CD) receiving ABP501 or SB5 biosimilars from January 2019 to April 2020 for moderate-to-severe disease. For comparison, a group of age- and sex-matched patients treated with adalimumab originator was used. We collected clinical and biochemical data after induction and at 6 months of treatment. Endoscopic data were recorded only at baseline. RESULTS Overall, clinical benefit was achieved by 86.4% and 85.3% after induction and at 6 months, respectively, without a statistically significant difference between the three treatment groups (p = 0.68 and p = 0.46). However, after induction, we found significant differences between the two types of the disease (ulcerative colitis or CD, p = 0.004), with a greater clinical benefit achieved by patients with CD. Also, the therapeutic optimization rate between the three drugs was not statistically significant different (p = 0.30). All treatments showed a good safety profile, with only 10 patients who needed to stop therapy because of adverse events. CONCLUSION Adalimumab biosimilars seem to be as effective and safe as the originator in patients with IBD. Surely, they represent a great opportunity to reduce the costs of biological therapies, however larger and longer real-life studies are necessary.
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Affiliation(s)
| | | | - Cristina Canova
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giulia Barbieri
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Renato Sablich
- Gastroenterology Unit, Santa Maria degli Angeli Hospital, Pordenone, Friuli-Venezia Giulia, Italy
| | - Maria Teresa Urbano
- Gastroenterology Unit, Santa Maria degli Angeli Hospital, Pordenone, Friuli-Venezia Giulia, Italy
| | - Lorenzo Bertani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Francesco Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giorgia Bodini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Maria Giulia Demarzo
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Antonio Ferronato
- Endoscopy Unit, Alto Vicentino Hospital, AULSS7 Pedemontana, Santorso, Veneto, Italy
| | - Andrea Buda
- Gastroenterology Unit, Hospital Feltre, Italy
| | - Piera Melatti
- Department of Surgery, Oncology, Gastroenterology, University of Padua, Padua, Veneto, Italy
| | - Davide Massimi
- Department of Surgery, Oncology, Gastroenterology, University of Padua, Padua, Veneto, Italy
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