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Doctor’s aptitude for switching from innovator etanercept to biosimilar etanercept in inflammatory rheumatic diseases: experience from a single French rheumatology tertiary care center

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Abstract

Objectives

To describe the switch to biosimilar etanercept (bETN), evaluate factors associated with this switch, and evaluate the efficacy of this switch in a real-life setting

Methods

We included patients, from October 2016 to April 2017, with rheumatoid arthritis (RA) and spondyloarthritis (SpA) who received innovator ETN (iETN) for at least 6 months. After receiving information on biosimilars, all physicians were invited to propose a switch from iETN to bETN. Factors associated with bETN discontinuation were explored by univariate and multivariate analyses. We estimated the proportion of patients still on bETN over time by Kaplan-Meier survival analysis. We assessed serum trough concentrations of iETN and bETN and anti-drug antibodies to ETN.

Results

Overall, 183 outpatients were eligible for a potential switch; 94 (51.6%) switched from iETN to bETN. The probability of a switch was greater with an older than younger aged physician (mean [SD] age 50.4 [14.3] with a switch vs 44.8 [11.3] with no switch, p = 0.005) and the physician having a full-time academic position than other position (56.4% with a switch vs 13.5% with no switch, p < 0.001). After a 6-month follow-up, bETN retention rate was 83% (95% CI: 0.76–0.92). The first cause of bETN discontinuation was inefficacy (50%). On multivariate analysis, no factor was independently associated with a bETN switch or discontinuation. Drug trough levels did not significantly differ by discontinuation or continuation of bETN. No patient showed anti-drug antibodies.

Conclusion

The probability of switching from iETN to bETN was likely related to physician characteristics.

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Acknowledgments

The authors would like to thank Theradiag for the anti-drug antibodies assessment.

Author information

Author notes

  1. Corinne Miceli-Richard and Maxime Dougados contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris, EULAR center of excellence, Paris Descartes University, Paris University, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France

    Omar Al Tabaa, Adrien Etcheto, Anna Moltó, Corinne Miceli-Richard & Maxime Dougados

  2. Department of Pharmacy, Cochin Hospital, AP-HP, Paris, France

    Sophie Dumas

  3. Department of Immunology, Cochin Hospital, AP-HP, Paris, France

    Frederic Batteux & Claire Goulvestre

  4. Sorbonne Paris-Cité, INSERM U1016, Cochin Institute, CARPEM, Paris Descartes University, Paris University, Paris, France

    Frederic Batteux

  5. INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France

    Anna Moltó & Maxime Dougados

  6. Immunoregulation Unit, Unité Mixte AP-HP/Institut Pasteur, Institut Pasteur, Paris, France

    Corinne Miceli-Richard & Maxime Dougados

Authors
  1. Omar Al Tabaa
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  2. Adrien Etcheto
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  3. Sophie Dumas
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  4. Frederic Batteux
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  5. Claire Goulvestre
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  6. Anna Moltó
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  7. Corinne Miceli-Richard
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  8. Maxime Dougados
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Corresponding author

Correspondence to Corinne Miceli-Richard.

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Highlights

• No factor was independently associated with the switch from iETN to bETN in RA and SpA patients.

• No factor was independently associated with bETN discontinuation in RA and SpA patients.

• The probability of switching from iETN to bETN was likely related to physician characteristics.

• Serum trough levels and immunogenicity did not differ between iETN and bETN.

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Al Tabaa, O., Etcheto, A., Dumas, S. et al. Doctor’s aptitude for switching from innovator etanercept to biosimilar etanercept in inflammatory rheumatic diseases: experience from a single French rheumatology tertiary care center. Eur J Clin Pharmacol 77, 25–33 (2021). https://doi.org/10.1007/s00228-020-02957-2

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  • DOI: https://doi.org/10.1007/s00228-020-02957-2

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