Drug Discontinuation and Persistent Symptoms Among Initiators of Bio-Originator and Biosimilar Anti–tumor Necrosis Factor Drugs in Inflammatory Bowel Disease: Real-world Contemporary Data From the CAnadian Network for Advanced Interdisciplinary Methods/CIRC Registry
Bibliographic record
Abstract
Background and aims: Biosimilars and their originator anti-tumor necrosis factor drugs remain important in inflammatory bowel diseases (IBDs). We assessed drug discontinuation, IBD symptoms, and quality of life (QoL) in adults after initiating infliximab and adalimumab bio-originators or biosimilars. Methods: Six Canadian IBD sites enrolled initiators of these drugs, between January 2019 and February 2024. We determined drug discontinuation, concomitant medications, and symptoms and QoL (using the Short Inflammatory Bowel Disease Questionnaire and 5-level EuroQol-5D) at 12 months after initiating therapy, and assessed differences between bio-originator and biosimilar users. Results: We evaluated 205 initiators of infliximab (N = 151) or adalimumab (N = 54) who had completed at least 12 months of follow-up. Within this time, 21.5% (n = 44) discontinued drug use. There were significant reductions in corticosteroid use, abdominal pain and bowel urgency among both bio-originator and biosimilar users. Significant reduction in overall pain/discomfort and fatigue was detected among biosimilar users only. There was a significant improvement in QoL on the Short Inflammatory Bowel Disease Questionnaire both in the bio-originator (mean difference 9.0, 95% confidence interval: 4.0-15.0) and biosimilar (9.0, 95% confidence interval: 6.0-12.0) groups. Conclusion: About 80% of individuals initiating infliximab or adalimumab for IBD were still on these drugs at 12 months. Benefits (including less corticosteroid use, abdominal pain, bowel urgency, and improved QoL) were seen in individuals initiating both biosimilar and bio-originators.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".