Researchers: Lianne Kearsley-Fleet, Aasiyah Rokad, Man-Fung Tsoi, Sizheng Steven Zhao, Mark Lunt, Kath D. Watson, BSRBR-RA Contributors Group, Kimme L. Hyrich.

What was already known?

Etanercept is one of the main treatment options for patients with rheumatoid arthritis (RA). In 2015, the patent for the original etanercept drug expired in Europe and since then other pharmaceutical companies have been able to make the drug; known as a biosimilar. Biosimilar therapies must demonstrate the same clinical effect as the original drug in clinical trials, and as a result many patients are made to switch between these therapies, as biosimilar drugs are usually much less expensive. This analysis was done to see whether adults with RA that are swapped from the original etanercept (the originator) onto an etanercept biosimilar do just as well as those patients who did not switch and remained on the original.

What was discovered?

This analysis included 1024 adults with RA from the British Society for Rheumatology Biologics Register for RA (BSRBR-RA) changing from the original etanercept to an etanercept biosimilar, and a matched group of patients who remained on the original. Those who swapped onto the biosimilar were just as likely to remain on their treatment (an indication that it is working for them without causing side effects severe enough to have to stop) compared with those who remained on the original. Two-in-three of all patients in both groups were still on therapy after three years indicating that both treatments (original and biosimilar) are controlling their arthritis. In addition, after six and 12 months of treatment, patients did equally well regarding ongoing control of their arthritis, in terms of symptoms, such as the number of swollen joints, regardless of whether they switched or not.

Why is this important/what is the benefit to patients?

This is one of the largest analyses of adults with RA that shows that those who switched from the original etanercept (the originator) to an etanercept biosimilar appear to do just as well with regards to their arthritis (disease activity) and how long they stay on drug, compared with those who remained on the original. This is reassuring to patients and the clinical team when a patient with RA is advised to swap treatment from the original to the biosimilar therapy.

Should you wish to read this scientific paper in full, the text can be found online here:

• Outcomes following switching from etanercept originator to etanercept biosimilar in 1024 patients with RA: a matched-analysis of the BSRBR-RA

Graphical abstract

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