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      Evaluación de la persistencia, tasa de retención y pauta de prescripción de infliximab original e infliximab CT-P13 en pacientes naive biológicos con colitis ulcerosa Translated title: Evaluation of persistence, retention “rate” and prescription pattern of original infliximab and infliximab CT-P13 in biologic-naïve patients with ulcerative colitis

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          Abstract

          Resumen Objetivo: Comparar la persistencia, tasa de retención y pauta de prescripción de infliximab original e infliximab CT-P13 en pacientes naive a biológicos con colitis ulcerosa. Método: Estudio ambispectivo de pacientes naive a biológicos en colitis ulcerosa que recibieron tratamiento en primera línea con Remicade® (infliximab) y Remsima® (infliximab CT-P13) de forma no simultánea durante un periodo de estudio de 10 años (2012-2021). Se tomaron datos de su edad, peso, persistencia, tasa de retención y si precisó de intensificación o desintensificación a lo largo del periodo de estudio. Se determinó el coste paciente/año real de Remicade® y Remsima® de forma individualizada en función de las administraciones durante el periodo del estudio. Resultados: Un total de 27 pacientes naive a biológicos fueron tratados con Remicade® y 53 con Remsima®. Ambos grupos de pacientes no presentaron diferencias en cuanto al peso y edad. La persistencia (mediana ± rango intercuartílico) con Remicade® fue de 42,49 ± 57,48 meses frente a 27,50 ± 58,50 meses para Remsima®, sin demostrar diferencias significati vas (p = 0,455). La tasa de retención a los 6, 12 y 24 meses fue del 81%, 63% y 33%, respectivamente, para el grupo de Remicade®, y del 71%, 47% y 37%, respectivamente, para el grupo de Remsima®. En el grupo de pacientes tratados con Remicade®, 9 pacientes fueron intensificados frente a 11 pacientes en el grupo de Remsima®. En cuanto a las desintensificaciones, 5 pacientes que recibieron tratamiento con Remicade® fueron desintensificados frente a 7 pacientes en tratamiento con Remsima®. El ahorro obtenido con el uso de Remsima® fue de 203.649 €, que equivaldría a tratar a 118 pacientes adicionales con infliximab biosimilar durante un año. Conclusiones: No existen diferencias significativas en la persistencia, tasa de retención y número de intensificaciones y desintensificaciones entre los pacientes naive que fueron tratados con Remicade® y aquellos tratados con Remsima®, siendo una alternativa eficaz, segura y económica en el tratamiento biológico de la colitis ulcerosa.

          Translated abstract

          Abstract Objective: To compare the persistence, retention rate and prescription pattern of original infliximab and infliximab CT-P13 in biologic-naïve patients with ulcerative colitis. Method: This was an ambispective study of biologic-naive patients with ulcerative colitis who received non-simultaneous first-line treatment with Remicade ® (infliximab) and Remsima® (infliximab CT-P13) over a 10-year study period (2012-2021). Data on their age, weight, persistence, retention rate and on whether they required intensification or deintensification throughout the study period was collected. The real patient/year cost of Remicade® and Remsima® was determined individually based on the amounts administered during the study period. Results: 27 biologic-naive patients were treated with Remicade® and 53 with Remsima®. Neither patient group presented with differences in terms of weight and age. Persistence (median ± interquartile range) with Remicade® was 42.49 ± 57.48 months, as compared to 27.50 ± 58.50 months for Remsima®, without significant differences (p = 0.455). The retention rate at 6, 12, and 24 months was 81%, 63%, and 33%, respectively, for the Remicade® group and 71%, 47%, and 37%, respectively, for the Remsima® group. Nine subjects in the Remicade® group vs 11 patients in the Remsima® group were intensified. Regarding deintensification, five patients treated with Remicade® were deintensified, as compared with 7 patients on Remsima®. Savings obtained with the use of Remsima® amounted to 203,649 €, which would allow treating an additional 118 patients with biosimilar infliximab for one year. Conclusions: There are no significant differences in persistence, retention, and number of intensifications or deintensifications between biologic-naïve patients treated with Remicade® and those treated with Remsima®, the latter being an effective, safe and economical alternative for the treatment of ulcerative colitis.

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          A new taxonomy for describing and defining adherence to medications.

          Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications', 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation', 'Implementation' and 'Discontinuation'. In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.
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            Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis.

            The comparative efficacy and safety of infliximab and azathioprine therapy alone or in combination for ulcerative colitis (UC) have not been evaluated previously. This randomized, double-blind trial evaluated the efficacy and safety of 16 weeks of treatment with infliximab monotherapy, azathioprine monotherapy, or the 2 drugs combined in tumor necrosis factor-a antagonist-naive adults with moderate to severe UC. Patients were assigned randomly to receive intravenous infusions of infliximab 5 mg/kg at weeks 0, 2, 6, and 14 plus daily oral placebo capsules; oral azathioprine 2.5 mg/kg daily plus placebo infusions on the infliximab schedule; or combination therapy with the 2 drugs. Corticosteroid-free clinical remission (primary end point, week 16) was evaluated at weeks 8 and 16. The study was terminated before the enrollment target was reached. A total of 239 patients were included in efficacy analyses. Baseline characteristics were similar between treatment groups. Corticosteroid-free remission at week 16 was achieved by 39.7% (31 of 78) of patients receiving infliximab/azathioprine,compared with 22.1% (17 of 77) receiving infliximab alone(P =.017) and 23.7% (18 of 76) receiving azathioprine alone(P =.032). Mucosal healing at week 16 occurred in 62.8% (49 of 78) of patients receiving infliximab/azathioprine, compared with 54.6% (42 of 77) receiving infliximab (P = .295) and 36.8% (28 of 76) receiving azathioprine (P =.001). Serious infections occurred in 2 patients (1 patient receiving infliximab,and 1 patient receiving azathioprine). Anti–tumor necrosis factor-a–naive patients with moderate to severe UC treated with infliximab plus azathioprine were more likely to achieve corticosteroid-free remission at 16 weeks than those receiving either monotherapy. Combination therapy led to significantly better mucosal healing than azathioprine monotherapy. ClinicalTrials.gov number, NCT00537316.
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              Induction infliximab levels among patients with acute severe ulcerative colitis compared with patients with moderately severe ulcerative colitis

              Infliximab is effective as salvage therapy for patients with steroid refractory acute severe ulcerative colitis (UC). Although current data suggest that the pharmacokinetics of infliximab are influenced by inflammatory burden in patients with acute severe UC, data comparing infliximab trough levels in patients with acute severe UC vs. moderately severe UC are scarce.
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                Author and article information

                Journal
                fh
                Farmacia Hospitalaria
                Farm Hosp.
                Grupo Aula Médica (Toledo, Toledo, Spain )
                1130-6343
                2171-8695
                October 2022
                : 46
                : 5
                : 296-300
                Affiliations
                [3] Sagunto Valencia orgnameHospital de Sagunto orgdiv1Servicio de Digestivo España
                [1] Alzira Valencia orgnameHospital de la Ribera orgdiv1Servicio de Farmacia España
                [2] Sagunto Valencia orgnameHospital de Sagunto orgdiv1Servicio de Farmacia España
                Article
                S1130-63432022000500004 S1130-6343(22)04600500004
                10.7399/fh.13232
                d06bdc7e-90eb-41aa-bc16-fff49bdb1685

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 22 February 2022
                : 08 April 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 5
                Product

                SciELO Spain

                Categories
                Originales

                Biosimilar pharmaceuticals,Infliximab,Infliximab CT-P13,Ulcerative colitis,Persistence,Retention rate,Fármaco biosimilar,Colitis ulcerosa,Persistencia,Tasa de retención

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