Choquette D, Chan J, Bardi M, Whiskin C, Torani G, Smith BK, Sihota A. Monitoring the transition of patients on biologics in rheumatoid arthritis: Consensus guidance for pharmacists.
Pharm Pract (Granada) 2021;
19:2377. [PMID:
34621449 PMCID:
PMC8455126 DOI:
10.18549/pharmpract.2021.3.2377]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background:
Recent approvals for novel agents such as the small molecule Janus kinase
inhibitors (JAKi), combined with the advent of biosimilars has widened the
gamut of available therapeutic options in the treatment of rheumatoid
arthritis (RA). This combined with the introduction of mandatory non-
medical switches to biosimilars in some jurisdictions by both public and
private payors has led to a significant increase in the volume of
therapeutic changes for patients. Pharmacists are well positioned to ensure
effective and safe transitions, however there is a significant unmet need
for objective and subjective clinical guidance around therapy as well
disease state monitoring in RA that facilitates best practices throughout
the patient journey.
Objective:
In this paper we aim to create a consensus derived monitoring algorithm for
pharmacists to facilitate best practices throughout therapeutic transitions
from originator biologic to other originator biologics, biosimilars, and
Janus kinase inhibitors in RA.
Methods:
The Nominal Group Technique (NGT) was used to understand if consensus could
be found among the participants. Clinically relevant questions were
developed to capture solutions to the identified unmet need. The faculty
considered the questions as individuals, and privately generated
answers/ideas. After discussion and consideration, the participants ranked
the ideas and established a consensus.
Results:
Based on the outcome of the consensus discussions, an algorithm was created
to help guide pharmacists through therapeutic transitions in RA. The tool
covers important topics such as pre-transition considerations, avoiding the
nocebo effect for biosimilars, specific considerations for each drug or
class, monitoring efficacy, and when to refer.
Conclusions:
New classes of anti-rheumatic drugs including JAKi, along with the
introduction of biosimilars are presenting more opportunity for therapeutic
changes and monitoring in patients with RA. We hope our evidence-based
consensus derived guidance tool will assist frontline pharmacists in
supporting their patients to a successful therapeutic transition in RA.
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