UK Providers Report Positive Results From Biosimilar Rituximab in Real-World Settings

At the 58th Annual Scientific Meeting of the British Society for Haematology, held from April 16-18, 2018, in Liverpool, United Kingdom, researchers from 2 hospitals reported on the use of biosimilar rituximab in real-world settings.

A Transition to Biosimilar Rituximab Leads to Offsite Chemotherapy and Improved Patient Experience

The University Hospital of Wales decided to change from using subcutaneous reference rituximab to intravenous biosimilar rituximab in order to generate cost savings in treating patients with B-cell lymphomas.¹ However, this change in administration route required an overhaul of the hospital’s chemotherapy service in order to create additional chair space to accommodate the time required to give the drug via infusion.

The hospital took the opportunity to move chemotherapy treatments to offsite, nurse-led centers—including a mobile center that could travel to meet patients’ needs—that were closer to patients’ homes, and a service improvement program was established to carry out the changes. Nurses were given enhanced training to allow them to work without onsite medical support, and regular working group meetings with stakeholders allowed for improvements in the process of delivering chemotherapy under the new process.

According to the hospital’s representatives, feedback from patients was overwhelmingly positive, and patients reported that they were pleased with their reduced travel times, the ease of parking at offsite units, and the prompt attention they received when arriving for their appointments.

The hospital reports that, after it deemed the pilot program successful, and because it had successfully freed up chair space to infuse the biosimilar therapy, it implemented a change to biosimilar rituximab in January 2018.

The overhaul of the hospital’s approach was achieved without an additional cost to the lymphoma service, and the biosimilar produced a substantial cost savings for the hospital. The offsite program is now slated for expansion, which will free up capacity at the hospital for clinical trial activity.

Biosimilar Rituximab Used Successfully in Chronic Immune Thrombocytopenia

Although chronic immune thrombocytopenia (cITP) is not an approved indication of rituximab, the drug (or its biosimilar) is frequently used to treat this disease on the basis of extrapolation from other indications, such as rheumatoid arthritis.

Researchers from the Withybush General Hospital collected data from their center on patients with cITP who had received either the reference or biosimilar rituximab (Truxima) over the past 3 years.²

In total, 10 patients received the reference drug and 5 received the biosimilar.

Among the patients who received the reference drug, all had an initial response, and 9 continue to have an ongoing response (1 relapsed within 3 months and required a different treatment). Of the 9 patients who continue to respond, 1 patient had a grade 2 infusion reaction, but this reaction did not necessitate discontinuation of treatment.

All of the patients who received the biosimilar had an initial response, and 1 relapsed within 4 months of treatment, necessitating a change of therapy. No patients had an infusion reaction related to the biosimilar.

While the researchers note that their numbers are small, they report that “The general trend of response with Truxima appears to be equivalent to the original product and no immediate safety issues have been noted.”

References

1. Bloodworth C, Myson V, Harries R, Lloyd C, Rowntree C. Creating off-site nurse led treatment units for administering chemotherapy to people with lymphoma nearer to their homes. Presented at the 58th Annual Scientific Meeting of the British Society for Haematology, April 16-18, 2018; Liverpool, United Kingdom. Abstract BSH18-OR-022. https://onlinelibrary.wiley.com/doi/10.1111/bjh.15226.

2. Kundu S, Grubb H. Single hospital retrospective review of the use of monoclonal antibody and its biosimilar Truxima in chronic immune thrombocytopenia. Presented at the 58th Annual Scientific Meeting of the British Society for Haematology, April 16-18, 2018; Liverpool, United Kingdom. Abstract BSH18-EP-010. https://onlinelibrary.wiley.com/doi/10.1111/bjh.15226.