In the United Kingdom, Biosimilars Are Increasingly Used as First-Line Therapy in JIA

Though the use of biosimilars is becoming more common in the adult arthritis space, there has been little research on their use in pediatric patients. Identifying the need for further analysis in this population, researchers conducted a study investigating biosimilar use in children and young adults with juvenile idiopathic arthritis (JIA). The results were presented last week at the British Society for Rheumatology’s Annual Conference held in Liverpool, United Kingdom.

Researchers launched the prospective study, Biologics for Children with Rheumatic Diseases (BCRD), in 2010, and it is currently ongoing. The study investigated children with JIA who were beginning biologic therapies.

The study investigated the use of 2 biosimilar infliximab brands (sold as Inflectra and Remsima, which are the same molecular entity) and biosimilar etanercept (sold as Benepali) available in the United Kingdom. Baseline data for the study were collected through questionnaires completed by the treating physician or clinical research nurse. Follow-up data collection, including measurement of disease activity scores and changes in drug therapy, took place at 6 months, 1 year, and then yearly thereafter.

From 2010 to 2017, 26 patients identified in the BCRD study were being treated with a biosimilar: 21 (81%) were treated with Remsima, 3 (12%) were treated with Inflectra, and 2 (8%) were treated with Benepali. Of these, 9 (35%) started a biosimilar as their first biologic therapy. One patient switched from originator infliximab to Remsima. Sixteen (62%) switched from a different biologic therapy.

Reasons for switching were the following:

• Efficacy (n = 8, 50%)
• Safety (n = 5, 31%)
• Efficacy and safety issues combined (n = 2, 13%)
• Needle phobia (n = 1, 6%)

Follow up at 6 months was conducted for 3 study participants, and 1-year follow up was available for 1 study participant. No serious adverse events had been reported at the time the data were presented, and all 4 follow-up patients continued on their respective biosimilar therapy.

Through this prospective study, research has suggested that biosimilars are being considered as first-line therapy options in treating JIA rather than the originator biologic, even though JIA is not an approved indication of these drugs in the United Kingdom. This phenomenon, the researchers say, may be due to the cost savings associated with the biosimilars.

Reference

De Cock D, Kearsley-Fleet L, Baidam E, et al. Biosimilar use in children and young people with juvenile idiopathic arthritis in a real-world setting in the United Kingdom. Abstract presented at The British Society for Rheumatology’s Annual Conference; May 1-3, 2018; Liverpool, United Kingdom. Abstract 28. abstractsonline.com/pp8/#!/4506/presentation/655.