P409 Non-medical reverse switch between the originator infliximab and its biosimilar in patients with inflammatory bowel disease: clinical outcomes and therapeutic drug monitoring
Bibliographic record
Abstract
Switching from the originator to a biosimilar infliximab (IFX) in patients with inflammatory bowel disease (IBD) has proven to be successful, although clinical evidence is lacking on reverse and/or multiple switching. The aim of the present study was to evaluate medium-term drug sustainability, safety and immunogenicity profile of reverse switching from a biosimilar to the originator IFX in a consecutive multi-centre real-life cohort. We performed a prospective observational study of 174 consecutive patients with IBD (136 with Crohn’s disease [CD] and 38 with ulcerative colitis [UC]) who were switched from the biosimilar infliximab CT-P13 to the originator Remicade during maintenance therapy. Previous exposure to the originator was 8% (n = 14). In September 2017, a non-medical reverse switch took place in all Hungarian patients from the biosimilar to the originator infliximab due to change in reimbursement policies. We collected clinical and biochemical information from patients at baseline (time of the switch) and 8, 16 and 24 weeks thereafter. Serum drug trough levels and anti-drug antibodies were measured at baseline and Week 16. Complicated disease behaviour and perianal manifestation was present in 39.7% and 48.5% of CD patients. 54.1% of UC patients had extensive colitis. Previous exposure to the originator was 8.0% (n = 14). There was no significant difference between the proportion of patients in clinical remission (based on Crohn’s disease Activity Index <150 points or no fistula drainage; partial Mayo score <3) at Week 8 before switch, at switch/baseline and at Week 16 and 24 (CD: 82.6/80.6/77.5/76.3%, p = 0.60; UC: 82.9/81.6/83.7/84.8%, p = 0.98). In all IBD patients, mean serum IFX trough levels were 5.33 µg/ml (SD: 4.70) at baseline and 5.69 µg/ml (SD: 4.94) at week 16 (p = 0.71). No significant differences were observed in anti-drug antibody (ADA) formation either (overall ADA positivity: 16.2% vs. 16.9% at baseline/week16; p = 0.87). Four infusion reactions occurred up to Week 24 follow-up. There was no difference in clinical outcomes or TDM between patients with or without previous exposure to the originator. This is the first real-life cohort on mandatory reversed switch from biosimilar to originator IFX in IBD patients. No significant changes were observed in trough levels or ADA status after the reversed switch in parallel with good medium-term drug sustainability. No new safety signals were detected.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".