A147 SIMILAR OUTCOMES IN PATIENTS SWITCHED TO INFLIXIMAB BIOSIMILARS COMPARED TO THOSE REMAINING ON REMICADE IN A BRITISH COLUMBIA INFLAMMATORY BOWEL DISEASE PRACTICE
Bibliographic record
Abstract
Abstract Background In 2019 the Canadian province of British Columbia (BC) launched an initiative to switch inflammatory bowel disease (IBD) patients on the infliximab originator, Remicade, to biosimilars Inflectra or Renflexis. Evidence shows that such switches can be made without compromising efficacy or safety of treatment. Aims We examined results in a large IBD practice, with the hypothesis that patients required to switch to a biosimilar would have similar remission rates to those who remained on Remicade. Methods A total of 113 patients were included in this retrospective chart study. 80 of these were switched to biosimilars and were compared with 33 who remained on Remicade based on availability of private or compassionate coverage. Individual patient timelines were created, the start set as when the mandated switch was discussed. Data was collected retrospectively for 6 months. Outcomes included remission status, occurrence of flares, adverse events, hospitalizations, and necessity of dosage or drug change. Results Pre-switch, 49 of the 113 patients were in complete remission on Remicade (43.4%). 27% of the Remicade patients and 28.8% of the biosimilar patients remained in complete remission throughout follow up (p=0.87). Of the patients who began the study in complete remission, similar numbers of patients in the Remicade and biosimilar groups experienced flares (11.1% vs 27.5%; p=0.3); adverse events (33.3% vs 25%; p=0.61) and hospitalizations (0% vs 5.0%; p=0.49) respectively. 6.1% of patients beginning the trial in complete remission required a change in medication after the switch, all of which were in the biosimilar group (0% vs 7.5%; p=0.39). Among all 113 patients in the study, there was a numerical difference between the Remicade group and biosimilar group of patients who required a change in medication to another biologic. While clinically important, this was not statistically significant (0% vs 8.8%; p=0.08). Other clinical outcomes were similar between Remicade and biosimilar patients in the full group of 113 patients. Conclusions IBD patients remaining on Remicade or switching to biosimilars demonstrated similar patient outcomes after a 6-month period. Funding Agencies None
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 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".