Efficacy and safety of subcutaneous infliximab versus adalimumab, etanercept and intravenous infliximab in patients with rheumatoid arthritis: a systematic literature review and meta-analysis

Roberto Caporali, Yannick Allanore, Rieke Alten, Bernard Combe, Patrick Durez, Florenzo Iannone, Mike T. Nurmohamed, Sang Joon Lee, Taek Sang Kwon, Jean Soo Choi, Gahee Park, Dae Hyun Yoo

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

Objectives: There are few comparative data for tumor necrosis factor inhibitors in patients with rheumatoid arthritis (RA). Methods: Historical data for reference product/biosimilar intravenous infliximab, or adalimumab and etanercept, were pooled and compared with phase 3 study results for a subcutaneous (SC) formulation of the infliximab biosimilar CT-P13, in a systematic review and meta-analysis (PROSPERO: CRD42019149621). Results: The authors identified 13 eligible controlled trials that randomized over 5400 participants to prespecified treatments of interest. Comparison with pooled historical data suggested a numerical advantage for CT-P13 SC over intravenous infliximab for almost every prespecified efficacy outcome evaluated, including Disease Activity Score in 28 joints (C-reactive protein/erythrocyte sedimentation rate), Clinical/Simplified Disease Activity Index scores, American College of Rheumatology responses, and multiple measures of disease remission and low disease activity; for the majority of outcomes, there was no overlap in 95% confidence intervals between groups. A numerical advantage for CT-P13 SC was also observed for safety outcomes (adverse events, infections, and discontinuations). Similar, but less marked, trends were observed for comparison with historical efficacy and safety data for adalimumab/etanercept. Conclusion: CT-P13 SC offers an improved or similar benefit-to-harm ratio compared with infliximab (intravenous) and adalimumab/etanercept, for the treatment of moderate-to-severe RA.
Original languageEnglish
Pages (from-to)85-99
Number of pages15
JournalExpert Review of Clinical Immunology
Volume17
Issue number1
Early online date2020
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Adalimumab
  • CT-P13
  • biosimilar
  • etanercept
  • infliximab
  • rheumatoid arthritis

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