Effective Switches to Biosimilars Feature in APLAR Research

During the 20th Asia Pacific League of Associations for Rheumatology (APLAR) Congress, held September 6 to 9 in Kaohsiung, Taiwan, researchers presented on real-world experience with switching to biosimilars in treating rheumatic diseases.

First, research from Frimley Park Hospital in Camberley, United Kingdom, reported on a switch from reference etanercept (Enbrel) to a biosimilar (Benepali).¹ The biosimilar agent was first brought to the UK marketplace in June 2016, and provided an opportunity for the local National Health Service trust partake in cost savings via a gain-sharing agreement.

Read more about UK hospitals and biosimilar switching.

The hospital collected data from clinic records for 103 patients with rheumatoid arthritis who were receiving etanercept. In total, 95% of these patients were switched to the biosimilar by February 2017. Prior to switching to the biosimilar, patients had a mean disease activity score in a count of 28 joints (DAS28) of 2.69. After the switch, the patients’ mean DAS28 score was 2.83, a change that was clinically insignificant.

Similarly, researchers from Queen Alexandra Hospital, in Portsmouth, United Kingdom, reported on switches to biosimilars of infliximab and etanercept in retrospective, observational audit of a cohort of 80 patients with RA.²

For 3 years, patients who had received reference infliximab (Remicade) and reference etanercept were stratified according to disease activity and were switched to available biosimilars.

When disease activity was measured by DAS28, in patients receiving infliximab who had remission or low disease activity (LDA), 87.5% had no change in disease activity, while 12.5% had disease worsening. In those with moderate to severe disease activity, 33.3% had no change, while 66.7% showed improvement.

In patients receiving etanercept, among those with remission or LDA, 91.7% remained stable. Of those with moderate to severe disease, 57.1% had no change in disease activity, while 42.9% showed improvement.

When patients were assessed by Power Doppler Ultrasound Score, disease activity correlated with DAS28 score in most cases. Overall, no statistically significant differences emerged between treatment with the reference drugs or biosimilars, say the investigators, noting that improvements in disease activity after switching could be due to placebo effect.

References

1. Hoshen D. Real world experience of etanercept biosimilar switching. Presented at the Asia Pacific League of Associations for Rheumatology Congress, September 6-9, 2018; Kaohsiung, Taiwan. Abstract FR072. doi: 10.1111/1756-185X.13361.

2. Ringer A, Bellenie H, Parkes M, Harvey G, Young-min S, Wong E. Switching from originators to biosimilars using DAS28 and ultrasound to measure disease activity: experience from Portsmouth, UK. Presented at the Asia Pacific League of Associations for Rheumatology Congress, September 6-9, 2018; Kaohsiung, Taiwan. Abstract FR076. doi: 10.1111/1756-185X.13361.