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Schmitz EMH, Boekema PJ, Straathof JWA, van Renswouw DC, Brunsveld L, Scharnhorst V, van de Poll MEC, Broeren MAC, Derijks LJJ. Switching from infliximab innovator to biosimilar in patients with inflammatory bowel disease: a 12-month multicentre observational prospective cohort study. Aliment Pharmacol Ther 2018; 47:356-363. [PMID: 29205444 DOI: 10.1111/apt.14453] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/01/2017] [Accepted: 11/14/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infliximab biosimilars have become available for treatment of inflammatory bowel disease (IBD). However, data showing long-term safety and effectiveness of biosimilars in IBD patients are limited. AIM To study prospectively the switch from infliximab innovator to biosimilar in an IBD cohort with 12 months follow-up to evaluate safety and effectiveness. METHODS Adult IBD patients from two hospitals treated with infliximab innovator (Remicade; Janssen Biotech, Horsham , Pennsylvania, USA) were switched to infliximab biosimilar (Inflectra; Hospira, Lake Forest, Illinois, USA) as part of routine care, but in a controlled setting. Blood samples were taken just before the first, second, fourth and seventh infusion of biosimilar. Infliximab trough levels, antibodies-to-infliximab (ATI), CRP and ESR were measured and disease activity scores were calculated. RESULTS Our cohort consisted of 133 IBD patients (64% CD, 36% UC). Before switching we found widely varying infliximab levels (median 3.5 μg/mL). ATI were detected in eight patients (6%). Most patients were in remission or had mild disease (CD: 82% UC: 90%). After switching to biosimilar, 35 patients (26%) discontinued therapy within 12 months, mostly due to subjective higher disease activity (9%) and adverse events (AE, 9.8%). AE included general malaise/fatigue (n = 7), arthralgia (n = 2), skin problems (n = 2) and infusion reactions (n = 2). No differences in IFX levels, CRP, and disease activity scores were found between the four time points (P ≥ .0917). CONCLUSIONS We found no differences in drug levels and disease activity between infliximab innovator and biosimilar in our IBD cohort, indicating that biosimilars are safe and effective. The high proportions of discontinuers were mostly due to elective withdrawal or subjective disease worsening.
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Affiliation(s)
- E M H Schmitz
- Clinical Laboratory, Máxima Medical Center, Veldhoven, The Netherlands.,Expert Center Clinical Chemistry, Eindhoven, The Netherlands.,Clinical Laboratory, Catharina Hospital, Eindhoven, The Netherlands.,Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - P J Boekema
- Department of Gastroenterology, Máxima Medical Center, Eindhoven and Veldhoven, The Netherlands
| | - J W A Straathof
- Department of Gastroenterology, Máxima Medical Center, Eindhoven and Veldhoven, The Netherlands
| | - D C van Renswouw
- Department of Clinical Pharmacy, Elkerliek Hospital, Helmond, The Netherlands
| | - L Brunsveld
- Expert Center Clinical Chemistry, Eindhoven, The Netherlands.,Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - V Scharnhorst
- Expert Center Clinical Chemistry, Eindhoven, The Netherlands.,Clinical Laboratory, Catharina Hospital, Eindhoven, The Netherlands.,Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - M E C van de Poll
- Department of Clinical Pharmacy and Pharmacology, Máxima Medical Center, Veldhoven, The Netherlands
| | - M A C Broeren
- Clinical Laboratory, Máxima Medical Center, Veldhoven, The Netherlands.,Expert Center Clinical Chemistry, Eindhoven, The Netherlands
| | - L J J Derijks
- Department of Clinical Pharmacy and Pharmacology, Máxima Medical Center, Veldhoven, The Netherlands
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