Outcomes after anti-tumour necrosis factor originator to biosimilar switching in children and young people with juvenile idiopathic arthritis in the UK: a national cohort study
Main finding · Stopping treatment (drug persistence)Result — go to the resultHazard ratio 1.46 95% CI 0.93–2.30Authors' conclusion
Disease activity was similar between patients switching compared with those continuing the originator. Three quarters of patients were still receiving their biosimilar after 1 year, with switching back to originator uncommon, at only 9% after 1 year, suggesting good tolerability of non-medical switching in this patient population.
Study context
- Population
- Children and young people with non-systemic juvenile idiopathic arthritis (JIA) in the UK JIA Biologics Register, Jan 1, 2017, to July 7, 2023164 matched
- Participants
- 224 children
- Exposure
- Switch from anti-TNF originator to biosimilar of the same product vs continuing the originator
- Biosimilarn = 224
- Outcome
- Drug persistence (stopping treatment)
Methodological detailsnational cohort, matched (age, sex, disease duration, calendar year of originator start, line of therapy, ILAR category), Cox proportional hazard model, comparative effectiveness
- National cohort
- Matched (age, sex, disease duration, calendar year of originator start, line of therapy, ILAR category)
- Cox proportional hazard model
- Comparative effectiveness
Main finding
Stopping treatment (drug persistence)
Hazard ratio
1.46
95% CI 0.93–2.30
As reported in the abstract
Observational data: associations, not effects.
Further findings
JADAS-71 worsening, switching vs continuing originator (87 matched patients with available disease activity) · 6 months
- No evidence that JADAS-71 worsened more after 6 months; OR
- 0.71 (95% CI 0.34-1.51; p=0.38)
Outcomes in the 51 biosimilar patients who stopped treatment · last follow-up
- Switched back to originator (14 in the first year)
- 18 (35%)
- Started a different biological drug
- 28 (55%)
- Discontinued all treatment
- 5 (10%)
Original publication
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