1
|
Jin R, Kruppert S, Scholz F, Bardoulat I, Karzazi K, Morand F, Kricorian G, Collier D, Kay J. Treatment Persistence and Switching Patterns of Adalimumab Biosimilar ABP 501 in European Patients with Rheumatologic Diseases. Rheumatol Ther 2024; 11:523-537. [PMID: 38436916 PMCID: PMC11111632 DOI: 10.1007/s40744-024-00647-4] [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: 11/02/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION ABP 501 was an adalimumab (ADA) biosimilar approved for treating immune-mediated inflammatory diseases (IMIDs) including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). In this retrospective study, we aimed to examine the treatment patterns of ABP 501 among patients with these IMIDs using German and French pharmacy claims databases. METHODS Patients with RA, PsA, or AS who initiated ABP 501 between October 2018 and March 2020 and were observed continuously for ≥ 365 days both before and after ABP 501 initiation were included. Descriptive analyses of persistence and switch after ABP 501 discontinuation were conducted and reported for each disease cohort by prior use of ADA products (patients naïve to ADA or patients experienced with ADA). RESULTS Median (95% confidence interval) persistence on ABP 501 was 9.4 (8.6-10.3), 10.2 (9.0-11.7), and 12.1 (11.0-13.1) months in German patients, and 11.7 (9.9-13.3), 7.1 (5.8-8.4), and 10.8 (9.6-11.9) months in French patients for RA, PsA, and AS, respectively. For patients who switched from ABP 501 to another targeted therapy during the first 12 months of follow-up, switching patterns varied between patients naïve to ADA and patients experienced with ADA in both Germany and France, with patients naïve to ADA switching most frequently to other targeted therapies including non-ADA tumor necrosis factor inhibitor (TNFi), non-TNFi biologic, or Janus Kinase inhibitor (JAKi) and patients experienced with ADA switching most frequently back to ADA reference product (RP). CONCLUSIONS Across three rheumatologic diseases, about half of patients persisted on ABP 501 at the end of 12 months after treatment initiation in both Germany and France. Patients experienced with ADA were more likely to switch back to ADA RP, regardless of indication and country, suggesting a possible nocebo effect. Future studies are warranted to understand reasons of discontinuation and switching.
Collapse
Affiliation(s)
- Ran Jin
- Amgen Inc., Thousand Oaks, CA, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Jarab AS, Abu Heshmeh SR, Al Meslamani AZ. Examining the impact of biosimilar-to-biosimilar transition on effectiveness and safety. Expert Opin Biol Ther 2024:1-4. [PMID: 38404241 DOI: 10.1080/14712598.2024.2324123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/23/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Anan S Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
- Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| |
Collapse
|
3
|
Santoleri F, Lasala R, Abrate P, Pestrin L, Pasut E, Modesti G, Musicco F, Fulgenzio C, Zuzolo E, Pieri G, Roperti M, Gazzola P, Gambera M, Martignoni I, Montresor V, De Vita F, Guarino F, Grossi L, Di Fabio L, Roberti C, Spoltore C, Tinari G, De Rosa S, Giannini R, Langella R, Mingolla G, Piccoli M, Costantini A. ADA_ETA_BIO2021: real-world evaluation of adherence, persistence, and cost-effectiveness of originator and biosimilar biologic drugs in the treatment of rheumatoid arthritis: a multicenter study in Italy. Curr Med Res Opin 2023; 39:1729-1735. [PMID: 37994874 DOI: 10.1080/03007995.2023.2287600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES The objective was to assess the adherence, persistence, and costs of bDMARDs through a multicentre study of nine Italian hospital pharmacies. METHODS The drugs analysed were Abatacept, Adalimumab, Certolizumab, Etanercept, Golimumab and Tocilizumab.Adult subjects with Rheumatoid Arthritis were considered in the analysis.In this study, we calculated the following metrics: Adherence to treatment was evaluated as dose-intensity, which is the ratio between the amount of medication received and probably taken by the patient at home (Received Daily Dose, RDD) and the amount prescribed by the clinician (Prescribed Daily Dose, PDD). Persistence was calculated as the number of days between the first and last dispensing of the same drug. Lastly, costs were assessed based on persistence to treatment and normalized for adherence. RESULTS Adherence to treatment was found to be above 0.8 for all drugs studied. The median persistence for a 5-year treatment period was 1.4 years for Abatacept, 1.7 years for Adalimumab, 1.8 years for Certolizumab, 1.4 years for Etanercept, 1.3 years for Golimumab, and 1.6 years for Tocilizumab. CONCLUSIONS This multicentre retrospective observational study of bDMARDs used in the treatment of RA showed that, for all the drugs studied, there was no problem with adherence to treatment but rather a difficulty in maintaining treatment with the same drug over time.
Collapse
Affiliation(s)
| | - Ruggero Lasala
- Hospital Pharmacy of Corato, Local Health Unit of Bari, Bari, Italy
| | | | | | - Enrico Pasut
- Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy
| | - Germana Modesti
- Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy
| | - Felice Musicco
- San Gallicano Dermatological Institute - IRCCS, Rome Italy
| | | | - Eva Zuzolo
- San Gallicano Dermatological Institute - IRCCS, Rome Italy
| | | | | | - Pietro Gazzola
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Gambera
- "Ospedale P. Pederzoli" Casa di Cura Privata S.p.A.Via Monte Baldo
| | | | | | | | | | - Laura Grossi
- Chieti General Hospital, Via dei Vestini, Chieti Italy
| | | | | | | | | | | | | | - Roberto Langella
- Pharmacy Department, Agency for Health Protection (ATS) of Milan,Italy
| | | | | | | |
Collapse
|
4
|
de Oliveira Ascef B, Almeida MO, de Medeiros-Ribeiro AC, de Oliveira Andrade DC, de Oliveira Junior HA, de Soárez PC. Impact of switching between reference biologics and biosimilars of tumour necrosis factor inhibitors for rheumatoid arthritis: a systematic review and network meta-analysis. Sci Rep 2023; 13:13699. [PMID: 37607959 PMCID: PMC10444768 DOI: 10.1038/s41598-023-40222-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
What is the impact of switching between biologics and biosimilars of adalimumab, etanercept, and infliximab on efficacy and safety for rheumatoid arthritis? A systematic review and network meta-analysis were performed to compare switching and non-switching groups of treatments. Pooled Risk Relative (RR) or standardised mean differences (SMD) with 95% credible intervals (95% CrIs) were obtained. Seventeen randomized trials with a switching phase involving 6,562 patients were included. Results showed that a single switch from biologics to biosimilars compared to continuing biologics had comparable effects for primary and co-primary outcomes, the American College of Rheumatology criteria with 20% response (ACR20) (7 trials, 1,926 patients, RR 0.98, 95% CrIs 0.93 to 1.03) and the Health Assessment Questionnaire-Disability Index (HAQ-DI) (5 trials, 1,609 patients, SMD - 0.07, 95% CrIs - 0.23 to 0.1), and within the equivalence margins: ACR20 [RR 0.94, 1.06] and HAQ-DI [SMD - 0.22, 0.22]. The risk of treatment-emergent adverse events, discontinuation, and positive anti-drug antibodies were comparable after switching. Safety results were imprecise, and the follow-up period might not be sufficient to evaluate long-term effects, especially malignancies. Overall, the practice of single switching between approved biologics and biosimilars of Tumour Necrosis Factor inhibitors is efficacious and safe for rheumatoid arthritis.
Collapse
Affiliation(s)
- Bruna de Oliveira Ascef
- Departamento de Medicina Preventiva, Faculdade de Medicina - FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - 2º andar - sala 2214, São Paulo, SP, 01246-903, Brazil.
| | | | - Ana Cristina de Medeiros-Ribeiro
- Disciplina de Reumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | | | - Patrícia Coelho de Soárez
- Departamento de Medicina Preventiva, Faculdade de Medicina - FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| |
Collapse
|
5
|
Lasala R, Abrate P, Zovi A, Santoleri F. Safety and Effectiveness of Multiple Switching Between Originators and Biosimilars: Literature Review and Status Report on Interchangeability. Ther Innov Regul Sci 2023; 57:352-364. [PMID: 36322326 DOI: 10.1007/s43441-022-00473-2] [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: 07/10/2022] [Accepted: 10/14/2022] [Indexed: 02/09/2023]
Abstract
To date, numerous biosimilars are available in Europe and the practice of switching between originator and biosimilar or between two different biosimilars has become very widespread. However, multiple switching has not been adequately studied. The aim of this study is to conduct a literature review to assess the effectiveness and safety of multiple switches. All PubMed articles involving multiple switches from originator to biosimilars or between different biosimilars were considered. The relevant data on effectiveness and safety were extracted from these studies and the results were reported through descriptive analysis. Fifteen studies were considered, of which 11 were observational and 4 clinical trials. Inflammatory bowel disease and psoriasis were the most studied diseases. All studies reported that the effectiveness and safety in patients whose treatment involved multiple switches, was comparable to patients whose treatment involved a single or no switch at all. Some therapeutic fields such as oncology and renal insufficiency were not represented at all in the multiple switch studies. New evidence is desperately needed and should be made available to the scientific community and decision-makers.
Collapse
|
6
|
Shubow S, Sun Q, Nguyen Phan AL, Hammell DC, Kane M, Lyman GH, Gibofsky A, Lichtenstein GR, Bloomgarden Z, Cross RK, Yim S, Polli JE, Wang YM. Prescriber Perspectives on Biosimilar Adoption and Potential Role of Clinical Pharmacology: A Workshop Summary. Clin Pharmacol Ther 2023; 113:37-49. [PMID: 36251545 PMCID: PMC10099086 DOI: 10.1002/cpt.2765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/02/2022] [Indexed: 12/24/2022]
Abstract
The approval and adoption of biosimilar products are essential to contain increasing healthcare costs and provide more affordable choices for patients. Despite steady progress in the number of the US Food and Drug Administration (FDA) biosimilar approvals over the years, biosimilar adoption in the United States has been slow and gradual, largely driven by payers rather than clinicians. In order to better understand the barriers to biosimilar adoption in the clinic, the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI) and the FDA jointly hosted a virtual workshop on April 13, 2022, titled "Biosimilars: A Decade of Experience and Future Directions - Strategies for Improving Biosimilar Adoption and the Potential Role of Clinical Pharmacology." This summary documents the experiences of four leading academic clinicians with specialties in oncology, rheumatology, gastroenterology, and endocrinology and their perspectives on how to increase biosimilar adoption, including the role of clinical pharmacology. Besides systemic changes in pricing and reimbursement, there is a need for additional education of a broad range of providers, including advanced care practitioners, and patients themselves. Educational efforts highlighting the rigor of the studies that support the approval of biosimilars-including the clinical pharmacology studies-and the benefits of biosimilars, can play a major role in improving biosimilar acceptance.
Collapse
Affiliation(s)
- Sophie Shubow
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Qin Sun
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Dana C Hammell
- School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - Maureen Kane
- School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - Gary H Lyman
- Department of Medicine, University of Washington, Seattle, Washington, USA.,Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Allan Gibofsky
- Division of Rheumatology, Weill Cornell College of Medicine, New York, New York, USA
| | - Gary R Lichtenstein
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Zachary Bloomgarden
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Raymond K Cross
- Division of Gastroenterology and Hepatology, Department Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sarah Yim
- Office of Therapeutic Biologics and Biosimilars, Office of New Drugs, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - James E Polli
- School of Pharmacy, University of Maryland, Baltimore, Maryland, USA
| | - Yow-Ming Wang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| |
Collapse
|
7
|
Kaneko K, Prieto-Alhambra D, Jacklin C, Bosworth A, Dickinson S, Berry S, McAteer H, Taylor PC. Influence of information provided prior to switching from Humira to biosimilar adalimumab on UK patients' satisfaction: a cross-sectional survey by patient organisations. BMJ Open 2022; 12:e050949. [PMID: 35172995 PMCID: PMC8852668 DOI: 10.1136/bmjopen-2021-050949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the perceptions and experiences of people with specific immune-mediated inflammatory diseases during the process of switching from Humira to biosimilar adalimumab. DESIGN Cross-sectional survey. SETTING An anonymised, self-administered, web-based survey. PARTICIPANTS The participants were drawn from members and non-members of either the National Rheumatoid Arthritis Society, the National Axial Spondyloarthritis Society, Crohn's and Colitis UK, or Psoriasis Association. Birdshot Uveitis Society and Olivia's Vision also signposted to the survey links. RESULTS A total of 899 people living with various immune mediated inflammatory diseases participated in this survey. Thirty-four per cent of respondents reported poor overall satisfaction with their biosimilar adalimumab after the switch, associated with complaints related to the switching process including lack of shared decision making, scarcity of information provided by or signposted to by the department instigating the switch as well as lack of training with the new injection device. Where training with the new device had been provided, there were significantly reduced reports of pain when injecting the new biosimilar (OR 0.20, 95% CI 0.07 to 0.55), side effects (OR 0.17, 95% CI 0.06 to 0.47) and difficulty in using the new injection device (OR 0.25, 95% CI 0.15 to 0.41). Self-reported side effects were reduced by (OR 0.13, 95% CI 0.05 to 0.38) when written information was provided by healthcare professionals and by (OR 0.15, 95% CI 0.05 to 0.42) with provision of verbal information. Difficulty in using the new injection device was also reduced by provision of satisfactory information such as written documents (OR 0.38, 95% CI 0.23 to 0.63) or by verbal communication with healthcare professionals (OR 0.45, 95% CI 0.27 to 0.73). Finally, provision of satisfactory written or verbal information was associated with a reduction in any negative perception regarding symptom control with the new biosimilar by (OR 0.05, 95% CI 0.004 to 0.57) and by (OR 0.15, 95% CI 0.03 to 0.84), respectively. CONCLUSIONS Patient reported experiences of the process of switching from originator to biosimilar emphasise the importance of clear communication, training and information in order to optimise perception and maximise achievable outcomes with the new treatment.
Collapse
Affiliation(s)
- Kayoko Kaneko
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Clare Jacklin
- National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK
| | - Ailsa Bosworth
- National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK
| | | | | | | | - Peter C Taylor
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| |
Collapse
|
8
|
Wei SJ, Zhang Q, Xiang YJ, Peng LY, Peng W, Ren Q, Gao YX. Guizhi-Shaoyao-Zhimu decoction attenuates bone erosion in rats that have collagen-induced arthritis via modulating NF-κB signalling to suppress osteoclastogenesis. PHARMACEUTICAL BIOLOGY 2021; 59:262-274. [PMID: 33626293 PMCID: PMC7906619 DOI: 10.1080/13880209.2021.1876100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
CONTEXT Guizhi-Shaoyao-Zhimu decoction (GSZD) is commonly used to treat rheumatoid arthritis (RA), but its mechanism is unclear. OBJECTIVE To investigate the effect of GSZD on bone erosion in type II collagen (CII)-induced arthritis (CIA) in rats and to identify the underlying mechanism. MATERIALS AND METHODS The CIA model was prepared in male Wistar rats by two subcutaneous injections of CII, 1 mg/mL. Fifty CIA rats were randomized equally into the control group given saline daily, the positive group given saline daily and methotrexate 0.75 mg/kg once a week, and three GSZD-treated groups gavaged daily with 800, 1600 and 3200 mg/kg of GSZD for 21 days. GSZD effects were assessed by paw volume, arthritic severity index and histopathology. Cytokine levels were determined by ELISA. The effects of GSZD on RAW264.7 cells were evaluated by receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and bone resorption assay. Expression of IκB-α and p65 was measured by Western blotting. Major components of GSZD were identified by HPLC. RESULTS Arthritis index score, paw volume and bone destruction score showed that GSZD improved inflammatory symptoms and reduced joint tissue erosion (p < 0.01). GSZD decreased RANKL, and the number of osteoclasts (OCs) in joint tissues (p < 0.01) and increased osteoprotegerin levels (p < 0.01). GSZD inhibited RANKL-induced RAW264.7 differentiation and reduced bone resorption by OCs. GSZD upregulated IκB (p < 0.01) and p65 (p < 0.01) in the cytoplasm and downregulated p65 (p < 0.01) in the cell nucleus. CONCLUSIONS Guizhi-Shaoyao-Zhimu decoction has an anti-RA effect, suggesting its possible use as a supplement and alternative drug therapy for RA.
Collapse
Affiliation(s)
- Shu-jun Wei
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qing Zhang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yong-jing Xiang
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lan-yu Peng
- Hospital of Chengdu, University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Peng
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- CONTACT Wei Peng School of Pharmacy, Chengdu University of Traditional Chinese Medicine, No. 1166 Liu-tai Road, Chengdu611130, China
| | - Qiang Ren
- Hospital of Chengdu, University of Traditional Chinese Medicine, Chengdu, China
- Qiang Ren Hospital of Chengdu, University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu610072, China
| | - Yong-xiang Gao
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Yong-xiang Gao International Education College, Chengdu University of Traditional Chinese Medicine, 37 Shi-er-qiao Rd., Jiuniu District, Chengdu610075, China
| |
Collapse
|
9
|
Mysler E, Azevedo VF, Danese S, Alvarez D, Iikuni N, Ingram B, Mueller M, Peyrin-Biroulet L. Biosimilar-to-Biosimilar Switching: What is the Rationale and Current Experience? Drugs 2021; 81:1859-1879. [PMID: 34705255 PMCID: PMC8578069 DOI: 10.1007/s40265-021-01610-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 01/15/2023]
Abstract
Over time, clinicians have become increasingly comfortable embracing the prescription of biosimilars-highly similar versions of innovator or reference biological agents-for their patients with inflammatory diseases. Although a switch from a reference product to a licensed biosimilar version (or vice versa) is a medical decision robustly supported by the stepwise accumulation of clinical trial evidence concerning comparable safety, immunogenicity, and efficacy between these products, a switch from one biosimilar to another biosimilar of the same reference product, or a cross-switch, is not. Similarity among biosimilars of a reference product is not a regulatory agency concern and therefore is unlikely to be investigated in randomized controlled trials in the foreseeable future. Yet in clinical practice, across a diverse range of patients, the option to cross-switch from one biosimilar to another can and does arise for valid reasons such as convenience or tolerability issues, or driven by third parties (e.g., payers). In the absence of clinical trial data, clinicians must attempt to objectively evaluate the emerging real-world cross-switching evidence within the context of what is known about the science underpinning a designation of biosimilar. That knowledge then needs to be integrated with what clinicians know about their patients and their disease on a case-by-case basis. This review aims to consolidate relevant emerging real-world data and other key information about biosimilar-to-biosimilar cross-switching for prescribing clinicians. In the absence of clear clinical guidelines addressing this topic at present, this review may serve to facilitate discretionary and educated treatment decision making.
Collapse
Affiliation(s)
- Eduardo Mysler
- Organización Médica de Investigación, Buenos Aires, Argentina.
| | - Valderilio Feijó Azevedo
- Rheumatology Unit, Department of Internal Medicine, Federal University of Paraná, Curitiba, PR, Brazil
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy
| | | | | | | | | | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm U1256 NGERE, University Hospital of Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| |
Collapse
|
10
|
Maccora I, Lombardi N, Crescioli G, Bettiol A, Bonaiuti R, Pagnini I, Maniscalco V, Marrani E, Mastrolia MV, Ravaldi C, Consolini R, Cattalini M, Vannacci A, Simonini G. OBSIDIAn - real world evidence of Originator to BioSImilar Drug switch in juvenile idiopathic arthritis. Rheumatology (Oxford) 2021; 61:1518-1528. [PMID: 34273158 DOI: 10.1093/rheumatology/keab572] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Limited data about use of biosimilars are available in children with Juvenile Idiopathic Arthritis (JIA). This study therefore aimed to evaluate long-term efficacy and safety of switching from etanercept (ETA) and adalimumab (ADA) originators to their biosimilars, in children with JIA, in a real-world setting. METHODS This is a retro-prospective non-interventional multicentre Italian comparative cohort study. Medical charts of JIA children treated with biosimilars of ETA or ADA were included. Efficacy and safety of TNF-inhibitors therapy was evaluated at last follow-up during originator and at 3, 6 and 12 months following the switch to biosimilar. RESULTS 59 children (42 female, median age at onset 88 months) were treated with biosimilar of ETA (21) and ADA (38). Forty-five switched from the originator to the BIO (17 ETA, 28 ADA). At time of switch, 12/17 patients on ETA and 18/28 on ADA were in remission. No significant difference has been found at 3, 6 and 12 months after the switch. Ten patients discontinued biosimilars due to disease remission (4 ETA, 3 ADA), family willing (1 ETA), occurrence of burning at injection site (1 ETA), and persistent activity (1 ADA). No statistically significant difference was observed between originator and BIOs, nor between originator and BIOs, and between ADA and ETA in time to disease remission achievement, time to relapse and number of patients who experienced AE. CONCLUSION Our real-life results seem to confirm the efficacy and safety profile of switching from originator of ADA and ETA to their respective BIOs also in paediatric patients with JIA.
Collapse
Affiliation(s)
- Ilaria Maccora
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy
| | - Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy.,Tuscan Regional Centre of Pharmacovigilance; Florence, Italy
| | - Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy.,Tuscan Regional Centre of Pharmacovigilance; Florence, Italy
| | - Alessandra Bettiol
- Department of Experimental and Clinical Medicine, University of Florence; Florence, Italy
| | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy
| | - Ilaria Pagnini
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy
| | - Valerio Maniscalco
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy
| | - Edoardo Marrani
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy
| | - Maria Vincenza Mastrolia
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy
| | - Claudia Ravaldi
- PeaRL - Perinatal Research Laboratory, University of Florence and CiaoLapo Foundation for Perinatal Health; Florence, Italy
| | - Rita Consolini
- Section of Clinical Immunology and Rheumatology, Division of Pediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Cattalini
- Pediatrics Clinic, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy.,Tuscan Regional Centre of Pharmacovigilance; Florence, Italy.,PeaRL - Perinatal Research Laboratory, University of Florence and CiaoLapo Foundation for Perinatal Health; Florence, Italy
| | - Gabriele Simonini
- Rheumatology Unit, Meyer Children's University Hospital; Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence; Florence, Italy
| |
Collapse
|
11
|
Lam SW, Amoline K, Marcum C, Leonard M. Healthcare system conversion to a biosimilar: Trials and tribulations. Am J Health Syst Pharm 2021; 78:2159-2163. [PMID: 34259801 DOI: 10.1093/ajhp/zxab279] [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: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE While biologic medications have transformed the care and management of millions of patients, they are a large financial strain on the healthcare system. Biosimilar medications present a great opportunity to improve care affordability. However, despite streamlined approval processes and the potential for cost savings, the acceptance and adaptation of biosimilars have been slow. This descriptive report illustrates the preparation for, challenges, and execution of an enterprise-wide biosimilar conversion within a large healthcare system. The 3 phases of biosimilar conversion utilized at our institution included selection of a biosimilar, pharmacy and therapeutics (P&T) committee approval, and implementation. SUMMARY When selecting a biosimilar, clinical data, medication safety, cost, institutional cost savings, payer coverage, patient assistance programs, and additional patient services should be taken into consideration to ensure patient care is not affected. Understanding and endorsement of biosimilar use by physician leadership, care managers, and pharmacists are crucial before implementation. P&T committee approval with clear delineation of the patient population (naive vs experienced), disease states, and whether the biosimilar would be the preferred medication should be obtained. Transparent communication of clear expectations to patients and coordination with the information technology (IT), contracting, and supply chain departments are necessary before the go-live date. Contracting and IT implementations should ideally take potential changes in biosimilar adaptation into consideration and have enough flexibility to account for these changes. Planned evaluations of patients' experiences with the change to the biosimilar should be incorporated as part of the implementation plan. CONCLUSION The barriers to biosimilar adaptation are plentiful. Careful planning, clear communication, and coordination with all affected disciplines can ensure successful biosimilar conversion.
Collapse
Affiliation(s)
- Simon W Lam
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Kevin Amoline
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | | | - Mandy Leonard
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
12
|
Alvarez DF, Wolbink G, Cronenberger C, Orazem J, Kay J. Interchangeability of Biosimilars: What Level of Clinical Evidence is Needed to Support the Interchangeability Designation in the United States? BioDrugs 2021; 34:723-732. [PMID: 32990892 PMCID: PMC7669758 DOI: 10.1007/s40259-020-00446-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A biosimilar is a biologic drug that is "highly similar to a reference (originator) product, with no clinically meaningful differences between the two products in safety, purity, and potency". Regulatory approval of a biosimilar is based on analytical, structural, and functional comparisons with the reference product, comparative nonclinical (in vivo) studies, clinical pharmacokinetics and/or pharmacodynamics, and immunogenicity. In addition, comparative clinical efficacy and safety assessments are usually conducted and, taken together, comprise the "totality of the evidence" supporting biosimilarity. For a biosimilar to meet the additional designation of interchangeability in the United States (US), the applicant must demonstrate that the biological drug can be expected to produce the "same clinical result as the reference product in any given patient" and "if the biological drug is administered more than once to an individual, the risk in terms of safety or diminished efficacy of alternating or switching between the use of the biological drug and the reference product is no greater than the risk of using the reference product without such alternation or switch". The challenges faced in conducting clinical studies to support a designation of interchangeability, as defined in the final interchangeability guidance from the US Food and Drug Administration, are considered. Potential alternative approaches to generating adequate and sufficient clinical data to support a designation of interchangeability are also presented.
Collapse
Affiliation(s)
- Daniel F Alvarez
- Inflammation and Immunology, Pfizer Inc, 500 Arcola Rd, Collegeville, PA, 19426, USA.
| | | | | | - John Orazem
- Global Biostatistics and Data Management, Pfizer Inc, New York, NY, USA
| | - Jonathan Kay
- Departments of Medicine and of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.,Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA
| |
Collapse
|
13
|
Hajji R. Biosimilars in rheumatic diseases. Int J Clin Pract 2021; 75:e13709. [PMID: 32940382 DOI: 10.1111/ijcp.13709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Raouf Hajji
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, Tunisie
- Hôpital de Sidi Bouzid, Service de Médecine Interne, Sidi Bouzid, Tunisie
| |
Collapse
|
14
|
Bag-Ozbek A, Hui-Yuen JS. Emerging B-Cell Therapies in Systemic Lupus Erythematosus. Ther Clin Risk Manag 2021; 17:39-54. [PMID: 33488082 PMCID: PMC7814238 DOI: 10.2147/tcrm.s252592] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease of unknown etiology, whose hallmark is the production of autoantibodies. B cells are promising targets for novel SLE therapies. In 2011, belimumab (Benlysta®), a fully humanized monoclonal antibody inhibiting B-cell activation and proliferation, was the first medication in 50 years to be approved by the US Food and Drug Administration to treat adult SLE. This review discusses the current experience with B-cell-targeted therapies, including those targeting B-cell-surface antigens (rituximab, ocrelizumab, ofatumumab, obinutuzumab, obexelimab, epratuzumab, daratumumab), B-cell survival factors (belimumab, tabalumab, atacicept, blisibimod), or B-cell intracellular functions (ibrutinib, fenebrutinib, proteasome inhibitors), for the management of SLE. It focuses on ongoing clinical trials and real-world post-marketing use, where available, including their safety profiles, and concludes with our recommendations for B-cell-centric approaches to the management of SLE.
Collapse
Affiliation(s)
- Ayse Bag-Ozbek
- Division of Rheumatology, Renaissance School of Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Joyce S Hui-Yuen
- Division of Pediatric Rheumatology, Steven and Alexandra Cohen Children Medical Center, New Hyde Park, NY, USA
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Autoimmune, Musculoskeletal, and Hematopoietic Diseases Research, Feinstein Institute for Medical Research, Manhasset, NY, USA
| |
Collapse
|
15
|
Ditto MC, Parisi S, Priora M, Sanna S, Peroni CL, Laganà A, D'Avolio A, Fusaro E. Efficacy and safety of a single switch from etanercept originator to etanercept biosimilar in a cohort of inflammatory arthritis. Sci Rep 2020; 10:16178. [PMID: 32999362 PMCID: PMC7527334 DOI: 10.1038/s41598-020-73183-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
AntiTNF-α biosimilars are broadly available for the treatment of inflammatory arthritis. There are a lot of data concerning the maintenance of clinical efficacy after switching from originators to biosimilars; therefore, such a transition is increasingly encouraged both in the US and Europe. However, there are reports about flares and adverse events (AE) as a non-medical switch remains controversial due to ethical and clinical implications (efficacy, safety, tolerability). The aim of our work was to evaluate the disease activity trend after switching from etanercept originator (oETA-Enbrel) to its biosimilar (bETA-SP4/Benepali) in a cohort of patients in Turin, Piedmont, Italy. In this area, the switch to biosimilars is stalwartly encouraged. We switched 87 patients who were in a clinical state of stability from oETA to bETA: 48 patients were affected by Rheumatoid Arthritis (RA),26 by Psoriatic Arthritis (PsA) and 13 by Ankylosing Spondylitis (AS).We evaluated VAS-pain, Global-Health, CRP, number of swollen and tender joints, Disease Activity Score on 28 joints (DAS28) for RA, Disease Activity in Psoriatic Arthritis (DAPSA) for PsA, Health Assessment Questionnaire (HAQ) and Health Assessment Questionnaire for the spondyloarthropathies (HAQ-S),Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS patients. 11/85 patients (12.6%) stopped treatment after switching to biosimilar etanercept. No difference was found between oETA and bETA in terms of efficacy. However, some arthritis flare and AE were reported. Our data regarding maintenance of efficacy and percentage of discontinuation were in line with the existing literature.
Collapse
Affiliation(s)
- Maria Chiara Ditto
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
- Medical Science, Rheumatology Unit, Azienda Ospedaliera Universitaria di Padova, Padua, Italy.
| | - Simone Parisi
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marta Priora
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Sanna
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Clara Lisa Peroni
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Angela Laganà
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Turin, Italy
| | - Enrico Fusaro
- Department of General and Specialistic Medicine, Rheumatology Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
16
|
Abstract
Biosimilar use is limited in some healthcare systems because biosimilars are not well understood by many healthcare professionals and patients. The knowledge gap is exacerbated by disparagement of biosimilars and dissemination of misinformation, whether intentional or otherwise. There are several different types of disparagement and misinformation directed towards biosimilars as a class, including statements about biosimilar science or policy that are factually incorrect; misleading information, where the information is correct, but is provided out of context; incomplete information, where only partial or a limited set of facts are provided; creation of a false narrative, especially in scientific and medical literature, that provides a set of references to support incorrect conclusions; and negative message framing of factual statements to create a negative perception. Disparagement and misinformation about biosimilars can be countered by educational efforts, appropriate oversight, and regulatory activities with the option of enforcement action by governmental agencies, if warranted. Balanced educational materials about biosimilars should be made easily accessible. Physicians, nurses, pharmacists, and patient advocacy groups should work together to provide patients with consistent, positive messages about the value of biosimilars.
Collapse
|
17
|
Worthing AB. Scrutinizing the Frustrating Cost of Drugs: How Rebates and Step Therapy Inflate Medicare Part D Prices—and Possible Reforms. Arthritis Rheumatol 2020; 72:203-205. [DOI: 10.1002/art.41135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/08/2019] [Indexed: 11/09/2022]
|
18
|
Pharmacologic Management of Rheumatoid Arthritis. Orthop Nurs 2019; 38:390-395. [PMID: 31764904 DOI: 10.1097/nor.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune inflammatory disease of the joints, which can result in permanent cartilage and bone damage. Although the exact cause of RA is unknown, there are many risk factors that have been associated with RA. When RA occurs, the immune system mistakenly attacks healthy synovial and connective tissue. Available treatment options work to reduce inflammation or slow the disease progression. The American College of Rheumatology published guidelines for the treatment of rheumatoid arthritis in 2015, with an update expected in late 2019/early 2020. Nonpharmacologic therapy for patients with RA includes rest, occupational and physical therapy, and weight reduction and use of assistive devices, as necessary. Pharmacologic options include nonsteroidal anti-inflammatory drugs, corticosteroids, disease-modifying antirheumatic drugs, antitumor necrosis factor agents, and interleukin receptor antagonists.
Collapse
|
19
|
Cantini F, Benucci M, Li Gobbi F, Franchi G, Niccoli L. Biosimilars for the treatment of psoriatic arthritis. Expert Rev Clin Immunol 2019; 15:1195-1203. [DOI: 10.1080/1744666x.2020.1682553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Maurizio Benucci
- Consultant in Rheumatology, Rheumatology Clinic, Azienda USL Toscana Centro, Nuovo S. Giovanni di Dio Hospital, Florence, Italy
| | - Francesca Li Gobbi
- Consultant in Rheumatology, Rheumatology Clinic, Azienda USL Toscana Centro, Nuovo S. Giovanni di Dio Hospital, Florence, Italy
| | - Giulia Franchi
- Rheumatology Department, Hospital of Prato, Prato, Italy
| | - Laura Niccoli
- Rheumatology Department, Hospital of Prato, Prato, Italy
| |
Collapse
|
20
|
Renton WD, Leveret H, Guly C, Smee H, Leveret J, Ramanan AV. Same but different? A thematic analysis on adalimumab biosimilar switching among patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:67. [PMID: 31585539 PMCID: PMC6778384 DOI: 10.1186/s12969-019-0366-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/05/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Biologic medications have dramatically enhanced the treatment of many chronic paediatric inflammatory conditions. Their high cost is a factor that prohibits their broader use. Cheaper generic versions, or biosimilars, are increasingly being used. Healthcare services are switching some patients over to biosimilars for economic reasons, known as 'non-medical switching'. Some patients unsuccessfully switch due to perceived decreases in efficacy or non-specific drug effects. The implications of failed switching include exhaustion of therapeutic options, unnecessary exposure to other medications, increased healthcare utilisation, worse patient outcomes and higher overall healthcare costs. Patient perceptions almost certainly play a role in these 'failed switches'. METHODS A thematic analysis was performed to better understand patient and parent perceptions on non-medical biosimilar switching. The study was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research recommendations. Patients with juvenile idiopathic arthritis currently taking adalimumab were included. RESULTS Nine families were interviewed just prior to a hospital trust-wide non-medical switch to an adalimumab biosimilar. Several common themes were identified. The most frequent concerns were regarding practical aspects of the switch including the medication administration device type; the colour of the medication and administration device; and whether the injections would sting more. The relative safety and efficacy of the biosimilar was raised although most families felt that there would be no significant difference. Anxieties about the switch were largely placated by reassurances from the medical team. CONCLUSIONS We derived recommendations based on existing adult literature and the observations from our study to optimise the benefits from non-medical biosimilar switching.
Collapse
Affiliation(s)
- William D. Renton
- 0000 0004 0399 4960grid.415172.4Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Helen Leveret
- 0000 0004 0399 4960grid.415172.4Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Catherine Guly
- 0000 0004 0399 4581grid.415175.3Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Heather Smee
- 0000 0004 0399 4960grid.415172.4Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Jamie Leveret
- 0000 0004 0399 4960grid.415172.4Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Athimalaipet V. Ramanan
- 0000 0004 0399 4960grid.415172.4Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK ,0000 0004 1936 7603grid.5337.2Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
21
|
Stamp LK, Chan SJ, Marra C, Helme C, Treharne GJ. Tapering biologic therapy for people with rheumatoid arthritis in remission: A review of patient perspectives and associated clinical evidence. Musculoskeletal Care 2019; 17:161-169. [PMID: 31148375 DOI: 10.1002/msc.1404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/10/2019] [Accepted: 04/13/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Biologic therapies have increased the control of disease activity in rheumatoid arthritis (RA). Questions remain about tapering biologics when remission is achieved in RA. The patient perspective has to be incorporated in pragmatic applications of tapering but is rarely accounted for in clinical studies of tapering. The aim of the present review was to summarize the evidence about RA patient perspectives on biologic tapering. METHODS We provided a narrative summary of the currently small body of research on patient perspectives retrieved through systematic searches with an emphasis on seeking qualitative research. In addition, we provided an update on relevant clinical research and financial considerations that frame the findings on patient perspectives. RESULTS Financial considerations around commencing/continuing on biologic therapies in RA vary internationally and have implications for patient perspectives. Recent clinical studies indicate that the benefit of tapering biologic therapy when in remission are predicted by drug concentration and aspects of disease activity, severity and duration. Three major concerns have been identified from studies of patient perspectives on biologic tapering: (a) disease relapse; (b) access to treatment in the case of disease flare when tapering; and (c) local motivation for dose reduction (i.e., driven by funding or health benefit). CONCLUSIONS More research is needed on tapering biologics, and should include studies of patient perspectives as well as health economic evaluations. Patient decision aids are a potential way of applying clinical and patient-focused evidence to help all parties come to a decision, but require developmental research and pragmatic evaluation.
Collapse
Affiliation(s)
- Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, Aotearoa/New Zealand
| | - Suz Jack Chan
- School of Pharmacy, University of Otago, Dunedin, Aotearoa/New Zealand
| | - Carlo Marra
- School of Pharmacy, University of Otago, Dunedin, Aotearoa/New Zealand
| | - Caitlin Helme
- Department of Psychology, University of Otago, Dunedin, Aotearoa/New Zealand
| | - Gareth J Treharne
- Department of Psychology, University of Otago, Dunedin, Aotearoa/New Zealand
| |
Collapse
|
22
|
Cohen SB, Czeloth N, Lee E, Klimiuk PA, Peter N, Jayadeva G. Long-term safety, efficacy, and immunogenicity of adalimumab biosimilar BI 695501 and adalimumab reference product in patients with moderately-to-severely active rheumatoid arthritis: results from a phase 3b extension study (VOLTAIRE-RAext). Expert Opin Biol Ther 2019; 19:1097-1105. [DOI: 10.1080/14712598.2019.1645114] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Stanley B. Cohen
- Department of Internal Medicine, Metroplex Clinical Research Center, Dallas, TX, USA
| | | | - Eric Lee
- Inland Rheumatology, Upland, CA, USA
| | - Piotr A. Klimiuk
- Department of Rheumatology and Internal Diseases, Medical University of Bialystok and Gabinet Internistyczno-Reumatologiczny, Bialystok, Poland
| | - Nuala Peter
- Medical, Boehringer Ingelheim, Biberach, Germany
| | | |
Collapse
|
23
|
Abstract
BACKGROUND Biosimilars provide opportunities for improving healthcare access and outcomes and reducing overall healthcare costs for patients with cancer. OBJECTIVES The purpose of this article is to explore the history of biosimilars, regulatory pathways, and barriers to biosimilar approval. This article also aims to describe the patient and clinician barriers to biosimilars use and the progress that has been achieved since the first biosimilar approval in Europe in 2006 and in the United States in 2015. METHODS A literature search was conducted to retrieve articles that are highly relevant to the history of biosimilars development and regulatory pathways in the United States, Europe, Asia, and Canada. Patient and clinician perspectives on safety issues and concerns regarding immunogenicity and bioequivalence that limit use of biosimilars are also included. FINDINGS Patient and provider concerns regarding immunologic patient safety issues, such as immunogenicity, lack of comparability, and low biosimilarity, still exist. The clinical safety, efficacy, and tolerability of biosimilars are among the top concerns in patients, prescribers, and clinicians.
Collapse
|
24
|
Economic Impact of Non-Medical Switching from Originator Biologics to Biosimilars: A Systematic Literature Review. Adv Ther 2019; 36:1851-1877. [PMID: 31168766 PMCID: PMC6822838 DOI: 10.1007/s12325-019-00998-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Indexed: 12/14/2022]
Abstract
Introduction A systematic literature review was conducted to review and summarize the economic impact of non-medical switching (NMS) from biologic originators to their biosimilars (i.e., switching a patient’s medication for reasons irrelevant to the patient’s health). Methods English publications reporting healthcare resource utilization (HRU) or costs associated with biosimilar NMS were searched in PubMed and EMBASE over the past 10 years and from selected scientific conferences over the past 3 years, along with gray literature for all biologics with an approved biosimilar (e.g., tumor-necrosis factor inhibitors, erythropoiesis-stimulating agents, insulin and hormone therapies). Results A total of 1311 publications were retrieved, where 54 studies met the selection criteria. Seventeen studies reported increased real-world HRU or costs related to biosimilar NMS, e.g., higher rates of surgery (11%), steroid use (13%) and biosimilar dose escalating (6–35.4%). Among the studies that the estimated cost impact associated with NMS, 33 reported drug costs reduction, 12 reported healthcare costs post-NMS without a detailed breakdown, and 5 reported NMS setup and managing costs. Cost estimation/simulation studies demonstrated the cost reduction associated with NMS. However, variation across studies was substantial because of heterogeneity in study designs and assumptions (e.g., disease areas, scenarios of drug price discount rates, cost components, population size, study period, etc.). Conclusion Real-world studies reporting the economic impact of biosimilar NMS separately from drug costs are emerging, and those that reported such results found increased HRU in patients with biosimilar NMS. Studies of cost estimation have been largely limited to drug prices. Comprehensive evaluation of the economic impact of NMS should incorporate all important elements of healthcare service needs such as drug price, biologic rebates, HRU, NMS program setup, administration and monitoring costs. Funding AbbVie. Electronic Supplementary Material The online version of this article (10.1007/s12325-019-00998-3) contains supplementary material, which is available to authorized users.
Collapse
|
25
|
Abstract
Biosimilars are copies of biologic medications, which no longer are protected by patent, that are intended to be marketed at lower prices than their reference products to increase patient access to treatment. Because a biosimilar must have equivalent pharmacokinetic parameters and efficacy and comparable safety and immunogenicity with its reference product, the only significant difference between the two should be cost. Lower-priced biosimilars are intended to introduce market competition. The availability of biosimilars should yield savings for the health care system and improve treatment outcomes by expanding patient access to effective medications. However, patients should partake of these cost savings.
Collapse
Affiliation(s)
- Jonathan Kay
- Rheumatology Center, Memorial Campus, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA.
| |
Collapse
|
26
|
Abstract
Rheumatoid arthritis (RA) is a common systemic inflammatory autoimmune disease characterized by painful, swollen joints that can severely impair physical function and quality of life. The presenting symptoms of musculoskeletal pain, swelling, and stiffness are common in clinical practice, so familiarity with diagnosing and managing RA is crucial. Patients with RA are at greater risk for serious infection, respiratory disease, osteoporosis, cardiovascular disease, cancer, and mortality than the general population. In recent years, early diagnosis, aggressive treatment, and expanded therapeutic options of disease-modifying antirheumatic drugs have markedly improved both the management and long-term prognosis of RA.
Collapse
Affiliation(s)
- Jeffrey A Sparks
- From Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. (J.A.S.)
| |
Collapse
|
27
|
Gimeno-Gracia M, Gargallo-Puyuelo CJ, Gomollón F. Bioequivalence studies with anti-TNF biosimilars. Expert Opin Biol Ther 2018; 19:1031-1043. [PMID: 30574813 DOI: 10.1080/14712598.2019.1561851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: Biosimilars, as defined by the European Medicines Agency, have been used in Europe since 2006. The landscape was considerably expanded when the first biosimilar of a monoclonal was approved and introduced in the European market. CT-P13 was developed by Celltrion as an infliximab biosimilar in 2013, not without controversy. As these complex molecules cannot be completely identical, some experts, clinicians, and even patients were skeptical regarding the real bioequivalence of the drugs. Currently, several new infliximab and adalimumab biosimilars are available or will reach the market in a few months. Areas covered: Our goal is to review, mainly from a clinical perspective, the available evidence for bioequivalence of anti-TNF biosimilars. We aim to take into account not only preclinical studies, mostly done for regulatory issues, but also data from clinical studies. Expert opinion: We can conclude that bioequivalence with originator is well demonstrated in those drugs which have followed European Medicines Agency regulatory pathways. Switching from originator to biosimilar appears safe for all indications. However, there are few data available for switching from one biosimilar to another, or for complete interchangeability. Prospective studies and strict pharmacovigilance are recommended.
Collapse
Affiliation(s)
- Mercedes Gimeno-Gracia
- Service of Pharmacy, Hospital Clínico Universitario "Lozano Blesa", IIS Aragón , Zaragoza , Spain
| | - Carla J Gargallo-Puyuelo
- Digestive Diseases Service, Hospital Clínico Universitario "Lozano Blesa", IIS Aragón, CIBEREHD , Zaragoza , Spain
| | - Fernando Gomollón
- Departamento de Medicina, Facultad de Medicina, Digestive Diseases Service, Hospital Clínico Universitario "Lozano Blesa", IIS Aragón, CIBEREHD , Zaragoza , Spain
| |
Collapse
|
28
|
Abstract
BACKGROUND The recent approval of reference etanercept (re-ETN) biosimilars SB4, GP2015, and HD203 produced relevant changes in the management of rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis due to the considerably lower cost of these products and the consequent savings. AIMS To review the pharmacodynamics, pharmacokinetics, efficacy, and safety of ETN biosimilars when employed as first-line therapy or after transition from re-ETN. Patients' acceptability was also addressed. EVIDENCE REVIEW The available literature was reviewed through a search of PubMed database, and abstract books of the American College for Rheumatology and European League Against Rheumatism annual meetings. SB4, GP2015, and HD203 were licensed by the US, European and South Korea regulatory agencies after the bioequivalence to re-ETN was demonstrated through pharmacodynamic and pharmacokinetic studies, and randomized, head to head, controlled trials. Based on the evidence of efficacy and safety of SB4 and HD203 in RA, and of GP2015 in psoriasis, by the extrapolation principle, the three biosimilars were approved for all indications licensed for re-ETN, and the regulatory agencies introduced the interchangeability from the originator to the biosimilar. Extrapolation of indications, and particularly interchangeability raised relevant concerns among the rheumatologists due to the low level of evidence supporting the switching strategy (or transition). Rheumatologists' concerns are oriented toward the relevant number of biosimilar discontinuations after the transition ranging from 7%-17% over a short-term follow-up period. As resulted from two studies, at least 20%-30% of the patients claimed more exhaustive information on the switching procedure. CONCLUSION Based on the available evidence, re-ETN biosimilars may be a good option as first-line therapy, while further data are needed to definitively establish the efficacy, safety, and the economic reflexes of transitioning from re-ETN.
Collapse
|
29
|
Fleischmann R. Editorial: The American College of Rheumatology White Paper on Biosimilars: It Isn't All White-There Is Some Gray and Black. Arthritis Rheumatol 2018; 70:323-325. [DOI: 10.1002/art.40402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 12/15/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Roy Fleischmann
- Metroplex Clinical Research Center; Dallas
- University of Texas Southwestern Medical Center; Dallas
| |
Collapse
|