Comparing the Effectiveness and Safety Associated With Infliximab vs Infliximab-abda Therapy for Patients With Hidradenitis Suppurativa

Abstract

IMPORTANCEAlthough limited effective and affordable treatment options exist for hidradenitis suppurativa, recent studies describe the effectiveness of a medical therapy, infliximab, for the treatment of hidradenitis suppurativa. Cost-saving biosimilar alternatives have recently become available, but no data currently exist on their safety and effectiveness.OBJECTIVE To evaluate the effectiveness of infliximab-abda vs infliximab administration associated with the treatment of hidradenitis suppurativa. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study identified patients treated with infliximab or infliximab-abda between 2016 and 2020 at the dermatology clinic at the University of North Carolina at Chapel Hill. The study population included patients who met the clinical criteria for hidradenitis suppurativa and had received a continuous dose of infliximab or infliximab-abda for at least 10 weeks. In total, 62 potential participants were identified using clinical tracking lists on the electronic medical records, and 34 participants were included in the final analysis.EXPOSURES Patients who started receiving infliximab or infliximab-abda were clinically tracked for a minimum of 10 weeks using the electronic medical record system, beginning at the time of drug initiation. Patients received loading doses of 10 mg/kg at weeks 0, 2, and 6, and then treatment was continued with a maintenance dose administered every 4 to 8 weeks. MAIN OUTCOMES AND MEASURESThe primary outcome measure was Hidradenitis Suppurativa Clinical Response, defined as at least 50% decrease in inflammatory nodule count without any increase in number of abscesses or draining sinuses. RESULTSOf 34 participants, 20 comprised the infliximab treatment group (mean [SD] age, 42.2 [13.2] years; 17 women [85%]), and 14 comprised the infliximab-abda treatment group (mean [SD] age, 35.5 [10.9] years; 13 women [93%]). The proportions of patients achieving a Hidradenitis Suppurativa Clinical Response were 71% (10 patients) in the infliximab-abda and 60% (12 patients) in the infliximab treatment group, which were not significantly different (P = .47).CONCLUSIONS AND RELEVANCE This cohort study found that both infliximab administration and infliximab-abda administration were associated with similar and significant improvement in disease as measured by the Hidradenitis Suppurativa Clinical Response. Infliximab-abda is likely a reasonable treatment option for hidradenitis suppurativa, and further research is warranted.

Switching from Adalimumab Originator to Biosimilar: Clinical Experience in Patients with Hidradenitis Suppurativa

“…Tolerability was also not assessed [24]. Regarding switching with other biologic agents in HS patients, it has been recently reported that infliximab administration and infliximab-abda administration have similar safety and effectiveness data by Hidradenitis Suppurativa Clinical Response [25].…”

Infliximab in hidradenitis suppurativa: A systematic review and meta‐analysis

“…Mean age of patients ranged from 16.4 to 44.4 years across studies. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Of studies that reported gender, 62.4% (173/277) were female. HS severity was reported as Hurley stage in 13 studies [5][6][7][8][11][12][13]15,16,18,19,21,22 and Hidradenitis Suppurativa Severity Index (HSSI) in one study.…”

New perspectives on the treatment of hidradenitis suppurativa

“…129 In a recent retrospective cohort study, the efficacy of IFX versus its biosimilar infliximab-abda has been found to be clinically equivalent (HiSCR 71% versus 60% at week 10, p = 0.47). 130 In a practice cohort study, drug survivals of ADA and IFX in HS have been found to be similar and rather low (30.5% and 48.6% at 24 months); treatment interruption was predominantly determined by ineffectiveness and side-effects. 131 Certolizumab pegol.…”

“…In a recent retrospective cohort study, the efficacy of IFX versus its biosimilar infliximab-abda has been found to be clinically equivalent (HiSCR 71% versus 60% at week 10, p = 0.47). 130…”