In a recent study conducted by researchers in Spain, it was found that patients with inflammatory arthritis who were prescribed biosimilar versions of etanercept or adalimumab were more likely to continue their treatment compared to those using the originator products. The discontinuation rates over a 2 to 3-year follow-up period were significantly lower for patients using biosimilars, with an adjusted hazard ratio in favor of biosimilars. However, the study did not provide clear reasons as to why patients preferred biosimilars over the originator products.
The study analyzed data from the Spanish registry called BIOBADASER, which includes patients with rheumatic diseases who are prescribed biologic or targeted synthetic drugs. The analysis focused on 4,162 patients who were prescribed either etanercept or adalimumab from 2016 to 2023. The findings revealed that patients with various forms of arthritis, including rheumatoid arthritis, juvenile idiopathic arthritis, axial spondyloarthritis, and psoriatic arthritis, were enrolled in the study. The mean follow-up period was around 2.5 years for etanercept and 1.8 years for adalimumab.
Factors Affecting Treatment Retention
Aside from using biosimilar versions of the drugs, the study identified other factors that predicted longer treatment retention. Patients with longer disease duration and those who were also taking methotrexate alongside the biologics were more likely to continue their treatment. On the other hand, patients who were using the biologics as a second- or later-line treatment had a higher risk of discontinuation. The study also found that the reason for discontinuing the biologics was often due to achieving remission, albeit being a rare occurrence.
Interestingly, nonmedical discontinuation – caused by factors such as supply shortages or hospitals’ strategic decisions – was more common for originator drugs compared to biosimilars. This suggests that other external factors may influence the decision to discontinue treatment. Additionally, some patients discontinued the biologics for reasons classified as “other,” such as pregnancy, loss to follow-up, or unexplained decisions, with no significant difference between biosimilars and originator products.
Study Limitations
While the study provided valuable insights into the impact of biosimilar biologic drugs on treatment retention in patients with inflammatory arthritis, there were several limitations to consider. The reliance on administrative records and the possibility of unmeasured confounders influencing the results could have introduced biases into the study findings. Further research may be needed to explore these factors in more detail.
The study highlights the importance of biosimilar versions of biologic drugs in improving treatment retention for patients with inflammatory arthritis. Understanding the factors that influence treatment continuation can help healthcare providers make more informed decisions when prescribing these medications. Further research in this area could provide additional insights into the benefits of biosimilars in clinical practice.
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