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  • Infliximab biosimilar linked to increased risk of uveitis flares

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    Review of: Recurrence Rates of Inflammation after Switching from the Originator Infliximab to Biosimilar Infliximab-abda for Noninfectious Uveitis

    Deaner J, Srivastava S, Hajj-Ali R, et al. American Journal of Ophthalmology, in press

    This retrospective study measured recurrence of inflammation after switching from original infliximab (Remicade) to a biosimilar for noninfectious uveitis.

    Study design

    Researchers assessed 17 patients with noninfectious uveitis who were switched from originator infliximab to biosimilar infliximab for nonmedical reasons. The main outcome measure was frequency of inflammation, defined as new or worsening inflammatory activity on exam or imaging.

    Outcomes

    Patients experienced more flares after switching from originator to biosimilar infliximab (0.19 vs. 0.92 per person-years, P=0.03). Of the 6 patients who flared after changing treatments, 4 did so within 90 days, suggesting that there may be some risk of inflammation associated with switching treatments. Three patients responded well and achieved quiescence with increased dosages of the biosimilar.

    Limitations

    This was a small, retrospective study with a limited control population.

    Clinical significance

    Patients changing from infliximab to biosimilar infliximab for uveitis should be closely observed, especially for the first 90 days. These patients tend to experience more flares after switching treatments but may achieve quiescence with increased biosimilar dosing.