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Use of infliximab biosimilar versus originator in a pediatric United Kingdom inflammatory bowel disease induction cohort

Lookup NU author(s): Dr Su Bunn

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Abstract

Copyright © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Objectives: The aim of the study was to summarize short-term effectiveness, safety, and cost of using infliximab biosimilar (IFX-B) drugs, (Inflectra [Hospira] and Remsima [NAAP]) compared to originator infliximab (IFX-O) (Remicade [MSD]) in biologic naive pediatric inflammatory bowel disease in the United Kingdom. Methods: Prospective audit of patients starting anti-tumour necrosis factor (TNF) therapy. Disease severity, response to treatment, and remission rate was measured by Pediatric Crohn's Disease Activity Index (PCDAI) and/or Physician Global Assessment. Results: Between March 2015 and February 2016, 278 patients (175 IFX-O, 82 IFX-B, and 21 Adalimumab) were started on anti-TNF therapy. This was compared with collected data on 398 patients started on IFX-O from 2011 to 2015. At initiation, median PCDAI was 36 (20,48) (n ¼ 42) in the IFX-O group and 28 (20,40) (n ¼ 29) in the IFX-B group, (P ¼ 0.08). Immunosuppression rates were similar: 150/175 (86%) for IFX-O and 65/82 (79%) for IFX-B (P > 0.05). Post induction, median PCDAI score was 5 (0,11) (n ¼ 19) and 0 (0,8) (n ¼ 15) in the IFX-O and IFX-B groups, respectively (P ¼ 0.35). There was no difference in response to treatment using Physician Global Assessment 85% (n ¼ 28) in IFX-O group and 86% (n ¼ 19) in IFX-B group (P > 0.05). Adverse events at initiation and post induction were not different between both groups (P > 0.05). Using conservative calculations, £875,000 would have been saved for a 1-year period with universal adoption of biosimilars in patients who were instead treated with IFX-O. Conclusions: IFX-B is likely as effective as IFX-O in treating IBD in comparable pediatric populations. Sites should adopt infliximab biosimilar for new starts due to cost reduction with no difference in other parameters.

Publication metadata

Author(s): Chanchlani N, Mortier K, Williams LJ, Muhammed R, Auth MKH, Cosgrove M, Fagbemi A, Fell J, Chong S, Zamvar V, Hyer W, Michael Bisset W, Morris M-A, Rodrigues A, Mitton SG, Bunn S, Mark Beattie R, Willmott A, Wilson DC, Russell RK

Publication type: Article

Publication status: Published

Journal: Journal of Pediatric Gastroenterology and Nutrition

Year: 2018

Volume: 67

Issue: 4

Pages: 513-519

Print publication date: 01/10/2018

Online publication date: 01/10/2018

Acceptance date: 02/04/2016

ISSN (print): 0277-2116

ISSN (electronic): 1536-4801

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1097/MPG.0000000000002011

DOI: 10.1097/MPG.0000000000002011

PubMed id: 29697550

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