FRI0101 NON-MEDICAL SWITCHING FROM ORIGINATOR TO BIOSIMILAR ETANERCEPT – NO EVIDENCE FOR A RELEVANT NOCEBO EFFECT – A RETROSPECTIVE ANALYSIS OF REAL-LIFE DATA
Authors: Uta Kiltz, Styliani Tsiami, Xenofon Baraliakos, Juergen Braun
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Real-world data about switching patients from originator product to a biosimilars are important to assess and to document the outcome of switches in clinical practice in order to confirm the low risk of major problems. It has been hypothesized that lack of efficacy and adverse drug events (ADEs) upon switching from reference biologics to biosimilar products are related to the nocebo effect [1]. <h3>Objectives</h3> To evaluate the effectiveness and safety of systematic non-medical switching from innovator etanercept to biosimilar etanercept SB4 in adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) in a real-life setting based on different information strategies before switching. <h3>Methods</h3> Data of all adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who had received innovator etanercept and were switched in our specialized center from innovator to biosimilar etanercept for economic reasons were retrospectively analysed. Whether or not patients were informed about the switch was left to the discretion of the treating physician. Disease activity and function were regularly assessed, and any changes were recorded in two consecutive visits at week 12 and 24. The scores documented at week 12 week after switching were taken as primary outcome. AEs were documented. <h3>Results</h3> A total of 84 patients were included (44 RA, 25 axSpA and 15 PsA patients), 24 of which had received information about switching (28.5%). The scores at week 12 of both, disease activity and function, remained rather unchanged (Table 1). Whether patients had been informed about switching or not did not influence outcomes or AE. The retention rate of the biosimilar was 96.4% (n=81) at week 12 and 87.6% (n=71) at week 24 (Figure 1). While 7 patients were lost to follow-up, 6 patients discontinued due to inefficacy or AE, including one malignant melanoma. Overall, 18 AEs were reported in 10 patients (12%). In 3 patients (3.6%) who had 5 AEs in the first 12 weeks the innovator was successfully re-administered. <h3>Conclusion</h3> Systematic switch from innovator to biosimilar etanercept was not associated with changes in disease activity or function in all three indications within 12 weeks. This was independent of information on the switch transmitted to the patients. Disclosure: Biogen GmbH funded this research. The Investigators retained full control of scientific and analytic content, and had final editorial responsibility. <h3>Reference</h3> [1] Kristensen, L.E., et al., Non-pharmacological Effects in Switching Medication: The Nocebo Effect in Switching from Originator to Biosimilar Agent. BioDrugs, 2018. 32(5): p. 397-404. <h3>Disclosure of Interests</h3> Uta Kiltz Grant/research support from: AbbVie, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB., Consultant for: AbbVie, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB., Styliani Tsiami: None declared, Xenofon Baraliakos Grant/research support from: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Centocor, Chugai, Janssen, MSD, Novartis, Pfizer Inc, Roche and UCB, Grant/research support from: AbbVie, Pfizer, Merck Sharp &amp; Dohme, UCB Pharma, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Janssen Biologics, Novartis, Pfizer, UCB Pharma, Galapagos, Speakers bureau: AbbVie, Chugai, Janssen, Novartis, Pfizer, UCB Pharma, Juergen Braun Shareholder of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson &amp; Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Consultant for: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson &amp; Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Speakers bureau: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB