Treatment of rheumatoid arthritis (RA) with Remicade (infliximab) is associated with lower rates of discontinuation among patients, compared to treatment with CT-P13 (a biosimilar of infliximab), according to results presented by Janssen Biotech at this year’s American College of Rheumatology/ARHP Annual Meeting.
Results were obtained in two studies evaluating the effectiveness of Remicade in comparison with CT-P13 in patients with RA. Both studies used patient data from the Turkish National Ministry of Health database, containing medical billing information for about 80% of the Turkish population.
The first study, “A Descriptive Analysis Of Real-World Treatment Patterns Of Innovator Infliximab (REMICADE®) And Biosimilar Infliximab In A Treatment Naïve Turkish Rheumatologic Disease Population,” analyzed medical billing data from 1,044 RA patients who recently had begun treatment with Remicade (80% of patients) or CT-P13 (20%). The analysis showed that six months after the therapy’s start, 44% of patients receiving CT-P13 discontinued their treatment, compared to 27% in the Remicade group.
The study also showed that the switching options among patients were different: Patients on CT-P13 switched to Remicade, whereas patients on this drug switched to another biologic therapy.
The second study, “A Descriptive Analysis Of Real-World Treatment Patterns In A Turkish Rheumatology Population That Continued Innovator Infliximab (REMICADE®) Therapy Or Switched To Biosimilar Infliximab,” analyzed the record of Turkish RA stable patients who sustained long-term treatment with Remicade, but switched to CT-P13. Of an initial group of 3,018 patients on long-term Remicade treatment, 148 switched to CT-P13. However, six months later, 70% of those patients discontinued their treatment. Of those who stayed with Remicade, only 24% discontinued over the same period. Among those who discontinued CT-P13, 85% switched back to Remicade.
“This real world evidence study raises important questions regarding the impact to patients and their healthcare professionals when patients who are stable on Remicade are switched to a biosimilar,” said Andrew Greenspan, MD, vice president of medical affairs at Janssen Biotech, in a press release.
“Both of these studies were not randomized and, therefore, it is not known what role selection bias or the switching process itself may have played in discontinuation rates. Nonetheless, fewer patients receiving appropriate treatment for a serious chronic condition is concerning and warrants further study. Patient well-being is our top priority, and we believe the decision to switch from Remicade to a biosimilar should be made by the treating physician in consultation with the patient,” Greenspan added.
Yusuf Yazici, MD, study author and rheumatologist at the New York University Hospital for Joint Diseases, concluded “These interesting findings indicate a need for further investigation to better understand factors that may lead to higher treatment discontinuation in patients taking the biosimilar CT-P13, compared to patients taking REMADE.”