Patient Perceptions of Switching From the Reference Adalimumab to Amjevita During Its Initial Launch

In a survey of patients with autoimmune arthritis who had been switched from reference adalimumab (Humira) to biosimilar adalimumab-atto (Amjevita; Amgen), 63% either preferred the biosimilar or had no preference for either, 87% had no concerns about losing disease control due to switching, and 49% reported adequate knowledge about the safety and efficacy of the biosimilar. The authors called for future research to “assess means to educate effectively patients on biosimilars’ safety and efficacy.”

Adalimumab is a monoclonal antibody to tumor necrosis factor (TNF)-α used to treat a variety of immune-mediated inflammatory diseases, such as rheumatoid arthritis. Amjevita was the first adalimumab biosimilar to enter the US market in January 2023. The reference product is available in citrate-containing and citrate-free formulations, the latter of which was developed to reduce injection site pain. Amjevita is available only as a citrate-free formulation.

The authors wrote that although a 2018 meta-analysis of 8 randomized controlled trials concluded are were no significant differences in safety and efficacy between adalimumab biosimilars and the reference product in rheumatoid arthritis (RA), no studies had assessed treatment satisfaction and product preference following a switch to adalimumab-atto in US patients with inflammatory arthritis.

The investigators conducted a telephone survey of adult patients with RA, ankylosing spondylitis, or psoriatic arthritis in Kaiser Permanente’s Southern California and Colorado regions who had recently switched from the originator to Amjevita. Of 1128 eligible patients, 243 patients completed the survey.

The questionnaire asked patients about their product preference, their concerns about biosimilar therapy, and any observed differences between the reference product and biosimilar.

Prior to switching, patients had been treated with the reference product for a median of 4.0 years. About 28% of patients reported preferring the biosimilar over the reference product, and 35% had no preference for either product.

Most patients (87%) reported having no concerns with losing control over their disease by switching from the reference product to the biosimilar. Almost half (45%) of patients who had previously been treated with the citrate-containing formulation of the reference adalimumab reported no differences immediately after injection of the biosimilar, and of those who did report a difference, most (92%) reported the biosimilar was more favorable regarding injection-site pain and discomfort.

Of those who had previously received the citrate-free formulation of the reference product, just over half (52.5%) reported no differences immediately after injection of the biosimilar. Most (80%) of those who did report a difference rated the reference product as more favorable. About half (49%) of patients felt they knew enough regarding the safety and efficacy of the biosimilar.

Most patients (90%) reported no concerns with the cost of the biosimilar. The authors concluded that Amjevita was overall “well received” by patients with autoimmune arthritis who switched from the reference product, but that future research should assess educating patients effectively prior to a switch from a reference product to a biosimilar.

Reference

Pham C, Niu F, Hui RL, Le KN, Delate T. Patient perceptions on switching from reference product adalimumab to biosimilar adalimumab-atto. Clin Rheumatol. 2024;43(3):1269-1270. doi:10.1007/s10067-023-06822-2.