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在全国范围内的炎症性肠病患者队列中,从原研英夫利昔单抗转换为单药或双药转换生物类似药的疗效和安全性。

The Efficacy and Safety of Switching From Originator Infliximab to Single or Double Switch Biosimilar Among a Nationwide Cohort of Inflammatory Bowel Disease Patients.

作者信息

Khan Nabeel, Patel Dhruvan, Pernes Tyler, Patel Manthankumar, Trivedi Chinmay, Medvedeva Elina, Xie Dawei, Yang Yu-Xiao

机构信息

Corporal Michael J Crescenz VA Medical Center, Department of Gastroenterology, Philadelphia, Pennsylvania, USA.

University of Pennsylvania, Perelman School of Medicine, Department of Medicine, Philadelphia, Pennsylvania, USA.

出版信息

Crohns Colitis 360. 2021 Apr 26;3(2):otab022. doi: 10.1093/crocol/otab022. eCollection 2021 Apr.

Abstract

BACKGROUND

Data on safety and efficacy of switching to Renflexis (SB2) from originator Infliximab (IFX) (single switch) or from originator IFX to Inflectra (CT-P13) to Renflexis (double switch) are limited.

METHODS

We conducted a retrospective cohort study in a nationwide cohort of patient with inflammatory bowel disease (IBD) in remission who were switched to SB2. The main exposure was the treatment course of SB2. There are 2 levels in this variable: single switch (IFX to SB2) and double switch (IFX to CT-P13 to SB2). The outcome is SB2 drug discontinuation rate and/or not being in remission after 1 year. Logistic regression was used to estimate the adjusted and unadjusted odds ratios with 95% confidence intervals to study the efficacy difference between single switch and double switch.

RESULTS

A total of 271 IBD patients were started on SB2. Among them 52 (19.2%) patients did not achieve remission at 1 year and 14 (5.1%) patients had to discontinue SB2 due to adverse events). In logistic regression analysis after controlling for covariates, there was no statistically significant difference observed in regard to efficacy or safety of the single switch versus double switch to SB2 (adjusted odds ratio for double switch compared to single switch = 1.33 (95% confidence interval 0.74-2.41, = 0.3432).

CONCLUSIONS

Among IBD patients in remission, double switch was equally effective as compared to a single switch. This will help reassure the gastroenterologists who have concerns regarding the safety and efficacy of switching between multiple biosimilars for treating IBD.

摘要

背景

从原研英夫利昔单抗(IFX)转换为雷夫利昔单抗(SB2)(单次转换),或从原研IFX转换为英夫利昔单抗(CT-P13)再转换为雷夫利昔单抗(双重转换)的安全性和有效性数据有限。

方法

我们在全国范围内对一组缓解期炎症性肠病(IBD)患者进行了一项回顾性队列研究,这些患者被转换为SB2治疗。主要暴露因素是SB2的治疗疗程。该变量有两个水平:单次转换(IFX转换为SB2)和双重转换(IFX转换为CT-P13再转换为SB2)。结局指标是SB2停药率和/或1年后未缓解率。采用逻辑回归分析来估计调整后的和未调整的比值比及95%置信区间,以研究单次转换和双重转换之间的疗效差异。

结果

共有271例IBD患者开始使用SB2治疗。其中,52例(19.2%)患者在1年后未达到缓解,14例(5.1%)患者因不良事件不得不停用SB2。在控制协变量后的逻辑回归分析中,对于转换为SB2的单次转换和双重转换,在疗效或安全性方面未观察到统计学上的显著差异(双重转换与单次转换相比的调整后比值比 = 1.33(95%置信区间0.74 - 2.41,P = 0.3432))。

结论

在缓解期的IBD患者中,双重转换与单次转换的效果相当。这将有助于消除胃肠病学家对在治疗IBD时在多种生物类似药之间转换的安全性和有效性的担忧。

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