Stable Patient Satisfaction Found After Switching From the Humira or Biosimilar CT-P17

A real-world study in France found patient satisfaction was stable after switching from either the reference product or a low-concentration adalimumab biosimilar to the adalimumab biosimilar CT-P17, a high-concentration, citrate-free formulation. More patients previously treated with an adalimumab biosimilar compared with the reference product reported increased satisfaction after switching. Also, more patients who switched from a citrate-containing vs citrate-free adalimumab product reported increased satisfaction. Additional survey findings suggested that patient education and shared decision making are important to treatment satisfaction, the authors said.

Adalimumab is a monoclonal antibody targeting tumor necrosis factor (TNF)-α, used to treat immune-mediated inflammatory diseases. The reference adalimumab (Humira) is available in its original lower-concentration formulation and a high-concentration, citrate-free formulation. Some adalimumab biosimilars use citrate as a buffer, and others are citrate-free; also, there are low- and high-concentration adalimumab biosimilars. The high-concentration, citrate-free reference product was developed aiming to reduce injection site pain. CT-P17 (Yuflyma; Celltrion) is a high-concentration, citrate-free adalimumab biosimilar, approved in Europe in 2021 for all indications of the reference product.

Although biosimilars are cost-effective, patient beliefs or concerns can affect their adherence to treatment and outcomes after a switch. A negative perception of biosimilars can lead to the nocebo effect, while inadequate training on a new injection device can result in poor adherence, and switching to a low-concentration or citrate-containing adalimumab biosimilar often results in more injection-site pain. This study evaluated patient expectations, experience, and satisfaction after switching from either the reference product or another adalimumab biosimilar to CT-P17. The prospective, real-world study evaluated data from online questionnaires from 189 adult patients with stable inflammatory bowel disease (IBD) or chronic inflammatory rheumatic diseases (CIRD) in 17 gastroenterology and 11 rheumatology private practices and hospitals across France.

Most patients (81%) with IBD had Crohn disease and more than half (54%) of those with CIRD had ankylosing spondylitis. The mean disease duration overall was 9 years. Most patients (72%-81%) were either in remission or had non-active disease when they switched to CT-P17. Slightly more than half (51%) switched from another adalimumab biosimilar, while 49% switched from the reference product. Of those who were previously receiving a biosimilar, 19% were receiving a biosimilar formulation containing citrate.

More patients who had been previously treated with an adalimumab biosimilar compared to the reference product had positive expectations of CT-P17 prior to switching, including expecting it would be easier to use, more comfortable, and less painful.

Before and after switching, 78% and 75% of patients were satisfied with adalimumab treatment, and 81% of patients had either the same or a higher level of satisfaction after compared to before switching. More patients reported an increase in satisfaction after switching from another adalimumab biosimilar (23%) than from the reference product (8%) and after switching from a citrate-containing biosimilar (29%) than from a citrate-free biosimilar (12%).

Multivariate models identified two individual factors associated with increased satisfaction after switching to CT-P17: previous treatment with an adalimumab biosimilar (as opposed to the reference product), and pain at the injection site under previous treatment. Also, fewer patients reported pain, redness, itching, or hematoma with CT-P17 compared to their previous treatment.

Results from the questionnaires also showed that 70% of patients felt they had received adequate information about CT-P17 before switching, understood the reason for the switch, were involved in the decision-making process, had their treatment preferences considered, and felt their physician listened to them.

The authors concluded that most patients in their study had either stable or increased treatment satisfaction after switching to CT-P17, and switching to CT-P17 from a citrate-containing adalimumab biosimilar was associated with increased patient satisfaction. They added that more patients who were convinced of the necessity of treatment were satisfied with CT-P17 than those who were not. “Patient fears and beliefs are important and should be taken into account, because concerns about biosimilars may lead to dissatisfaction, non-adherence, and loss of therapeutic benefit,” they wrote.

Reference

Bouguen G, Gossec L, Abitbol V, et al. Patient satisfaction and experience with CT-P17 following transition from reference adalimumab or another adalimumab biosimilar: results from the real-world YU-MATTER study. BioDrugs. 2024;38(6):867-878. doi:10.1007/s40259-024-00681-2