Clinical Practice of Adalimumab and Infliximab Biosimilar Treatment in Adult Patients With Crohn’s Disease

Abstract

<jats:title>Abstract</jats:title> <jats:p>The introduction of tumor necrosis factor (TNF) inhibitors has significantly changed the treatment landscape in Crohn’s disease (CD). The overall therapeutic achievements with TNF inhibitors such as infliximab, adalimumab, and certolizumab pegol paved the way to push the boundaries of treatment goals beyond symptomatic relief and toward cessation of objective signs of inflammation, including endoscopic remission. Even though these agents are widely used for the treatment of moderate to severe CD, heterogeneity still exists in translating evidence-based guidelines on the use of anti-TNF agents into actual treatment algorithms in CD. This might be due to several reasons including disparities in health expenditure policies; lack of harmonization between countries; and variations in assessment of disease severity, use of disease monitoring tools, or application of treatment targets by physicians. With the advent of biosimilars, patent-free versions of reference biologics are now available to minimize health inequalities in drug availability. In this context, this article aims to provide practical clinical guidance for the use of infliximab and adalimumab biosimilars in patients with moderate to severe CD by outlining different clinical scenarios that patients may encounter during their treatment journey.</jats:p>

Multiple Switches From the Originator Infliximab to Biosimilars Is Effective and Safe in Inflammatory Bowel Disease: A Prospective Multicenter Cohort Study

“…5 The introduction of biosimilars in clinical practice has raised a number of concerns, namely the extrapolation from other indications to IBD and the potential for subtle differences in attributes and tertiary and quaternary structure to result in increased immunogenicity. 6 Randomized trials 7,8 and prospective cohort studies [9][10][11] have not found convincing evidence for any of these reservations with single switches This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com from originator to biosimilar.…”

Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

“…However, the development of SC infliximab has shifted the landscape for anti-TNF therapy, among further advantages (Table 1 ). In the past, physicians could use infliximab for continuous IV therapy and adalimumab for continuous SC therapy in IBD [ 51 ], with additional SC anti-TNF options (including etanercept and golimumab) available for rheumatic diseases [ 42 ]. With only a few anti-TNF biologics available with dual formulations, a combination of IV loading and SC maintenance dosing was not a readily available option, although it may carry significant advantages for patients (including high peak serum drug levels with IV induction and constant serum drug levels with SC maintenance) [ 35 , 52 ].…”

“…Prior to the COVID-19 pandemic, SC anti-TNF agents were employed depending on patient preferences and physician recommendations [ 51 ], with surveys suggesting that both patients and physicians in rheumatology and gastroenterology settings prefer SC to IV biologics [ 53 – 55 ]. A survey of patients and HCPs from rheumatology clinics in Denmark revealed that 71% of patients currently self-injecting their treatment at home, 77% of biologic-naïve patients, and 87% of HCPs preferred the SC route of administration [ 53 ].…”

Biosimilar Uptake: The Importance of Healthcare Provider Education

“…One approach is for clinicians to develop standardized treatment guidelines for biosimilars. For a recent example of the development of treatment algorithms and decision trees for various clinical scenarios, consider the review article by Reinisch et al on the use of infliximab and adalimumab biosimilars in the treatment of moderate-to-severe Crohn’s disease [ 36 ]. Greater standardization has the benefit of reducing negative outcomes from variance introduced by treatment setting and clinician experience/expertise.…”