Switching from infliximab innovator to biosimilar in patients with inflammatory bowel disease: A 12-month multicentre observational prospective cohort study

E.M.H. Schmitz, P.J. Boekema, J.W.A. Straathof, D.C. van Renswouw, L. Brunsveld, V. Scharnhorst, M.E.C. van de Poll, M.A.C. Broeren, L.J.J. Derijks

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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.

Original languageEnglish
Pages (from-to)356-363
JournalAlimentary Pharmacology and Therapeutics
Volume47
Issue number3
Early online date2017
DOIs
Publication statusPublished - 1 Feb 2018

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Biosimilar Pharmaceuticals
Cohort Studies
Prospective Studies
Inflammatory Bowel Diseases
Infliximab
Inflammatory Bowel Disease 12
Safety
Antibodies
Arthralgia

Cite this

@article{4b084759244443d5a3e8ef3a86ab62bf,
title = "Switching from infliximab innovator to biosimilar in patients with inflammatory bowel disease: A 12-month multicentre observational prospective cohort study",
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.",
author = "E.M.H. Schmitz and P.J. Boekema and J.W.A. Straathof and {van Renswouw}, D.C. and L. Brunsveld and V. Scharnhorst and {van de Poll}, M.E.C. and M.A.C. Broeren and L.J.J. Derijks",
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Switching from infliximab innovator to biosimilar in patients with inflammatory bowel disease : A 12-month multicentre observational prospective cohort study. / Schmitz, E.M.H.; Boekema, P.J.; Straathof, J.W.A.; van Renswouw, D.C.; Brunsveld, L.; Scharnhorst, V.; van de Poll, M.E.C.; Broeren, M.A.C.; Derijks, L.J.J.

In: Alimentary Pharmacology and Therapeutics, Vol. 47, No. 3, 01.02.2018, p. 356-363.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Switching from infliximab innovator to biosimilar in patients with inflammatory bowel disease

T2 - A 12-month multicentre observational prospective cohort study

AU - Schmitz, E.M.H.

AU - Boekema, P.J.

AU - Straathof, J.W.A.

AU - van Renswouw, D.C.

AU - Brunsveld, L.

AU - Scharnhorst, V.

AU - van de Poll, M.E.C.

AU - Broeren, M.A.C.

AU - Derijks, L.J.J.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

AB - 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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U2 - 10.1111/apt.14453

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