Use of Infliximab Biosimilar Versus Originator in a Paediatric United Kingdom Inflammatory Bowel Disease Induction Cohort

Neil Chanchlani, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus K H Auth, Mike Cosgrove, Andrew Fagbemi, John Fell, Sonny Chong, Veena Zamvar, Warren Hyer, W Michael Bisset, Mary-Anne Morris, Astor Rodrigues, Sally G Mitton, Su Bunn, R Mark Beattie, Anne Willmott, David C Wilson, Richard K Russell

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: To summarize short-term effectiveness, safety, and cost of using infliximab biosimilar (IFX-B) drugs, (Inflectra™ and Remsima™) compared to originator infliximab (IFX-O) (Remicade®) in biologic naive pediatric inflammatory bowel disease in the United Kingdom.

METHODS: Prospective audit of patients starting anti-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 (PGA).

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 2011-15. At initiation, median PCDAI was 36 (20,48) (n = 42) in the IFX-O group and 28 (20,40) (n = 29) in the IFX-B group, (p = 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 = 19) and 0 (0,8) (n = 15) in the IFX-O and IFX-B groups respectively (p = 0.35). There was no difference in response to treatment using PGA 85% (n = 28) in IFX-O group and 86% (n = 19) in IFX-B group (p > 0.05). Adverse events (AE) at initiation and post induction were not different between both groups (p > 0.05). Using conservative calculations, £875,000 would have been saved over a one-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.

Original languageEnglish
JournalJournal of pediatric gastroenterology and nutrition
Early online date23 Apr 2018
DOIs
Publication statusE-pub ahead of print - 23 Apr 2018

Keywords

  • Journal Article

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