Department of Gastroenterology, Henri Mondor Hospital, AP-HP, EC2M3-EA 7375, Paris Est-Créteil (UPEC) Val de Marne University, Creteil, France.
Department of Gastroenterology, Cochin Hospital, AP-HP and University of Paris, Paris, France.
Aliment Pharmacol Ther. 2021 Apr;53(8):887-899. doi: 10.1111/apt.16312. Epub 2021 Mar 1.
There are few data regarding multiple switching from the originator Infliximab to its biosimilars.
To assess outcomes and patient perspectives in a prospective manner after double switching from Infliximab to the biosimilars CT-P13 and SB2.
A total of 158 consecutive patients with inflammatory bowel disease (IBD) receiving CT-P13 maintenance therapy were switched to SB2 and followed for 54 weeks. Patients were stratified according to previous switch from the originator Infliximab to CT-P13 (double switch group) or not (single switch group).
The drug persistence was high (94.9%) after 54 weeks. In total, 17 (10.8%) patients experienced loss of response to SB2, including 10 patients who were managed through dose optimisation and continued treatment. No changes were observed in clinical activity scores, fatigue, biological activity and pharmacokinetical parameters after the switch. The safety profile was in line with the current knowledge of Infliximab. According to the Beliefs about Medicines Questionnaire, the patients' perspectives did not change after switching from CT-P13 to SB2. The primary patient concerns remained after the switch, which were focused on effectiveness and safety rather than on the molecular differences between originator and biosimilars or socioeconomic benefits. There were also no differences in the concerns and beliefs between the double and single switch groups.
Double switching from the originator Infliximab to CT-P13 and then to SB2 was not associated with an impairment in patient beliefs, while the effectiveness, immunogeniity and safety of anti-TNF therapy remained stable after 54 weeks of follow-up.
关于从原研英夫利昔单抗转换为生物类似药的多次转换,目前数据较少。
前瞻性评估双重转换为英夫利昔单抗生物类似药 CT-P13 和 SB2 后患者的结局和观点。
158 例接受 CT-P13 维持治疗的炎症性肠病(IBD)患者连续入组,其中 131 例接受过英夫利昔单抗转换为 CT-P13(单次转换组),27 例在此基础上进一步转换为 SB2(双重转换组),随访 54 周。
54 周时药物持续率高(94.9%)。共计 17 例(10.8%)患者出现 SB2 无应答,其中 10 例通过剂量优化和继续治疗得到管理。转换后,临床活动评分、疲劳、生物活性和药代动力学参数无变化。安全性特征与英夫利昔单抗的现有知识一致。根据用药信念问卷,从 CT-P13 转换为 SB2 后,患者观点未发生改变。转换后患者仍主要关注药物的有效性和安全性,而不是原研药和生物类似药之间的分子差异或社会经济获益。单次转换组和双重转换组之间的关注点和信念也无差异。
从英夫利昔单抗原研药转换为 CT-P13,然后再转换为 SB2,不会影响患者的信念,且在 54 周的随访中,抗 TNF 治疗的有效性、免疫原性和安全性保持稳定。