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Sarlós P, Bikar A, Farkas N, Resál T, Szepes Z, Farkas K, Nagy F, Vincze Á, Miheller P, Molnár T. Self-reported efficacy and safety of infliximab and adalimumab biosimilars after non-medical switch in patients with inflammatory bowel disease: results of a multicenter survey. Expert Opin Biol Ther 2023; 23:827-832. [PMID: 37161387 DOI: 10.1080/14712598.2023.2211204] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Few data are available on subjective disease control and perception of adverse events (AEs) during switching from original anti-TNF agents to biosimilars. RESEARCH DESIGN AND METHODS Hungarian patients with inflammatory bowel disease were interviewed after a mandatory non-medical switch from an infliximab (IFX) originator to a biosimilar GP1111 or from an adalimumab (ADA) originator to a biosimilar GP2017. Drug choice was based on patient's and physician's decision. Subjective efficacy was measured using a 10-point scale, and AEs were assessed. Difference in efficacy before and after the switch was compared within and between the drugs. RESULTS Seventy-three ADA and 106 IFX switching patients were interviewed. Subjective efficacy of IFX biosimilar was rated lower compared to IFX originator (8.72 ± 1.68 vs. 7.77 ± 2.34; p = 0.001). The ADA biosimilar was rated higher than its originator (9.02 ± 1.61 vs. 8.42 ± 1.93; p = 0.017). Patients receiving ADA biosimilar were more satisfied with the new treatment compared to IFX (p = 0.032). The incidence of new AEs was 85% in the ADA and 55% in the IFX group (1.79 vs. 0.93 AEs per patient, respectively, p < 0.001). CONCLUSION Subjective efficacy of switching to a biosimilar was proven in case of ADA, while reduced efficacy was experienced with IFX biosimilar. Perception of AEs was high and varied between biosimilars.
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Affiliation(s)
- Patrícia Sarlós
- Department of Medicine, University of Pecs Medical School, Pecs, Hungary
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Alexander Bikar
- Department of Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Tamás Resál
- Department of Medicine, University of Szeged Albert Szent-Györgyi, Szeged, Hungary
| | - Zoltán Szepes
- Department of Medicine, University of Szeged Albert Szent-Györgyi, Szeged, Hungary
| | - Klaudia Farkas
- Department of Medicine, University of Szeged Albert Szent-Györgyi, Szeged, Hungary
| | - Ferenc Nagy
- Department of Medicine, University of Szeged Albert Szent-Györgyi, Szeged, Hungary
| | - Áron Vincze
- Department of Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Pal Miheller
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Tamás Molnár
- Department of Medicine, University of Szeged Albert Szent-Györgyi, Szeged, Hungary
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Hellström PM, Gemmen E, Ward HA, Koo H, Faccin F, Xue Z, Malmborg P. Switching from originator infliximab to biosimilar versus continuing on originator in inflammatory bowel disease: results from the observational Project NORTH study. Scand J Gastroenterol 2022; 57:1435-1442. [PMID: 35833832 DOI: 10.1080/00365521.2022.2090275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Project NORTH compared real-world clinical and economic outcomes in Swedish patients with inflammatory bowel disease (IBD) who switched from originator infliximab to its biosimilar. MATERIALS AND METHODS Data from electronic medical records and Swedish national registries were linked. Switchers (patients switching from originator infliximab to its biosimilar between 1 April 2014, and 31 December 2017) and non-switchers (patients who received originator infliximab and did not switch to a biosimilar by 31 December 2017) were followed up until 31 October 2019. RESULTS Baseline concomitant medication use, disease duration, and inflammatory markers were lower among switchers than non-switchers. At 6 months, the proportion of patients with stable disease was higher among switchers than non-switchers (71/109 [65%] vs 54/107 [50%]; p = .0385); differences were not significant in subsequent follow-ups. At 6 and 24 months, 98% and 93% of switchers, respectively, used concomitant medications versus 96% and 79% of non-switchers. Throughout the study, all-cause treatment discontinuation occurred in 74 (67%) switchers and 105 (95%) non-switchers. At 36-months, mean (SD) number of IBD-related in-patient care days was higher among non-switchers (2.95 [4.71]) than switchers (1.40 [4.20]), as were total medical costs (€16,740 vs €3,872). CONCLUSIONS No substantial differences in clinical outcomes or healthcare resource utilization were observed between switchers and non-switchers. Several analyses indicate that non-switchers might have more poorly controlled/severe disease than switchers at baseline. Overall, numerous difficulties might arise when executing a high-quality, real-world study, including possible selection bias for patients with better disease control for NMS, limiting the generalizability of the results.
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Affiliation(s)
- Per M Hellström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Eric Gemmen
- Epidemiology & Outcomes Research, IQVIA Real World Solutions, Cambridge, MA, USA
| | - Heather A Ward
- Epidemiology & Outcomes Research, IQVIA Real World Solutions, Cambridge, MA, USA
| | - Hyewon Koo
- Global Database Studies, Real World Solutions, IQVIA Solutions AB, Arenastaden, Sweden
| | - Freddy Faccin
- GMA Biotherapeutics, AbbVie Inc, San Juan, Puerto Rico
| | - Zhenyi Xue
- Global Medical Affairs Statistics, Data and Statistical Sciences, AbbVie Inc, North Chicago, IL, USA
| | - Petter Malmborg
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
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Weeda ER, Nguyen E, Martin S, Ingham M, Sobieraj DM, Bookhart BK, Coleman CI. The impact of non-medical switching among ambulatory patients: an updated systematic literature review. J Mark Access Health Policy 2019; 7:1678563. [PMID: 31692904 PMCID: PMC6818107 DOI: 10.1080/20016689.2019.1678563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/28/2019] [Accepted: 10/04/2019] [Indexed: 05/31/2023]
Abstract
Background: Non-medical switching (NMS) is defined as switching to a clinically similar but chemically distinct medication for reasons apart from lack of effectiveness, tolerability or adherence. Objective: To update a prior systematic review evaluating the impact of NMS on outcomes. Data sources: An updated search through 10/1/2018 in Medline and Web of Science was performed. Study selection: We included studies evaluating ≥25 patients and measuring the impact of NMS of drugs on ≥1 endpoint. Data extraction: The direction of association between NMS and endpoints was classified as negative, positive or neutral. Data synthesis: Thirty-eight studies contributed 154 endpoints. The direction of association was negative (n = 48; 31.2%) or neutral (n = 91; 59.1%) more often than it was positive (n = 15; 9.7%). Stratified by endpoint type, NMS was associated with a negative impact on clinical, economic, health-care utilization and medication-taking behavior in 26.9%,41.7%,30.3% and 75.0% of cases; with a positive effect seen in 3.0% (resource utilization) to 14.0% (clinical) of endpoints. Of the 92 endpoints from studies performed by the entity dictating the NMS, 88.0%were neutral or positive; whereas, only 40.3%of endpoints from studies conducted separately from the interested entity were neutral or positive. Conclusions: NMS was commonly associated with negative or neutral endpoints and was seldom associated with positive ones.
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Affiliation(s)
- Erin R. Weeda
- The College of Pharmacy, Medical University of South Carolina, Charleston, SC, USA
| | - Elaine Nguyen
- Department of Pharmacy Practice, Idaho State University College of Pharmacy, Boise, ID, USA
| | - Silas Martin
- Real World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Michael Ingham
- Real World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | | | - Brahim K. Bookhart
- Real World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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Müskens WD, Rongen-van Dartel SAA, Adang EMM, van Riel PLCM. Biosimilars in the management of chronic inflammatory diseases: The Dutch experience. Mediterr J Rheumatol 2019; 30:76-81. [PMID: 32524082 PMCID: PMC7280871 DOI: 10.31138/mjr.30.1.76] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/27/2022] Open
Abstract
These days, the use of biosimilars for the treatment of bio-naive patients is well established. However, the transition of patients being treated with a bio-originator to its biosimilar is still a topic of discussion. The main issue is which approach to use when initiating the non-medical transition. The first real-world examples contain both mandatory and non-mandatory approaches, resulting in a variety of acceptance and discontinuation rates. At this moment a non-mandatory approach, based on shared decision making, is preferred by international guidelines and the Task Force on the Use of Biosimilars to Treat Rheumatological Diseases. However, clear definitions of mandatory and non-mandatory are lacking, as a result of which these terms may be wrongly used in some studies. This article aims to provide an overview of transition approaches used in the Netherlands, and how the approach used relates to acceptance and discontinuation rates of the biosimilar.
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Affiliation(s)
| | - Sanne A A Rongen-van Dartel
- Department of IQ Healthcare, Radboudumc, Nijmegen, The Netherlands.,Department of Rheumatology, Bernhoven, Uden, The Netherlands
| | - Eddy M M Adang
- Department of Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Piet L C M van Riel
- Department of IQ Healthcare, Radboudumc, Nijmegen, The Netherlands.,Department of Rheumatology, Bernhoven, Uden, The Netherlands
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Abstract
OBJECTIVE This study aimed to describe real-world experiences following a non-medical switch among adults with type 2 diabetes mellitus (T2DM) in the United States. METHODS For this cross-sectional study, patients with T2DM (N = 451) provided data on demographics, and how a non-medical switch of their anti-hyperglycemic agent (AHA) affected their general health, HbA1c levels and medication management, via an Internet-based survey. Patients self-reported their level of satisfaction with the original medication and emotional reactions to the non-medical switch. Patients who recently experienced a non-medical switch of their AHA(s) (n = 379) were asked about the consequences of switching and their satisfaction with the switch (vs. the original) medication. RESULTS Patients most frequently reported feeling very/extremely frustrated, surprised, upset and angry in reaction to a non-medical switch. Patients were somewhat satisfied with their original medication. Between 20% and 30% of patients reported the non-medical switch had a moderate/major effect on their general health, diabetes, mental well-being and control over their health. The blood glucose levels of recent switchers were somewhat/much worse (20.7%) and medication management was somewhat/much worse (12.9%) on the switch (vs. the original) medication. Some recent switchers reported old symptoms returning (7.7%) and experiencing new side-effects (14.2%). CONCLUSIONS Approximately one in five patients reported a moderate/major negative impact on their blood glucose level, diabetes, mental well-being, general health and control over their health following a non-medical switch. Findings suggest that a non-medical switch may have unintended negative health consequences and results in considerable burden across multiple domains for a sizeable minority of patients with T2DM.
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Affiliation(s)
- Natalia M Flores
- a Health Outcomes Research , Kantar Health , Foster City , CA , USA
| | - Charmi A Patel
- b Health Economics & Outcomes Research , Janssen Pharmaceuticals Inc. , Titusville , NJ , USA
| | - Brahim K Bookhart
- b Health Economics & Outcomes Research , Janssen Pharmaceuticals Inc. , Titusville , NJ , USA
| | - Shaffeeulah Bacchus
- c Health Economics & Clinical Outcomes Research , Janssen Pharmaceuticals Inc. , Titusville , NJ , USA
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