Comparable long-term efficacy, as assessed by patient-reported outcomes, safety and pharmacokinetics, of CT-P13 and reference infliximab in patients with ankylosing spondylitis: 54-week results from the randomized, parallel-group PLANETAS study
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Background: CT-P13 (Remsima®, Inflectra®) is a biosimilar of the infliximab reference product (RP; Remicade®) and is approved in Europe and elsewhere, mostly for the same indications as RP. The aim of this study was to compare the 54-week efficacy, immunogenicity, pharmacokinetics (PK) and safety of CT-P13 with RP in patients with ankylosing spondylitis (AS), with a focus on patient-reported outcomes (PROs). Methods: This was a multinational, double-blind, parallel-group study in patients with active AS. Participants were randomized (1:1) to receive CT-P13 (5mg/kg) or RP (5mg/kg) at weeks 0, 2, 6 and then every 8weeks up to week 54. To assess responses, standardized assessment tools were used with an intention-to-treat analysis of observed data. Anti-drug antibodies (ADAs), PK parameters, and safety outcomes were also assessed. Results: Of 250 randomized patients (n = 125 per group), 210 (84.0%25) completed 54weeks of treatment, with similar completion rates between groups. At week 54, Assessment of Spondylo Arthritis international Society (ASAS)20 response, ASAS40 response and ASAS partial remission were comparable between treatment groups. Changes from baseline in PROs such as mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; CT-P13 -3.1 versus RP -2.8), Bath Ankylosing Spondylitis Functional Index (BASFI; -2.9 versus -2.7), and Short Form Health Survey (SF-36) scores (9.26 versus 10.13 for physical component summary; 7.30 versus 6.54 for mental component summary) were similar between treatment groups. At 54weeks, 19.5%25 and 23.0%25 of patients receiving CT-P13 and RP, respectively, had ADAs. All observed PK parameters of CT-P13 and RP, including maximum and minimum serum concentrations, were similar through 54weeks. The influence of ADAs on PK was similar in the two treatment groups. Most adverse events were mild or moderate in severity. There was no notable difference between treatment groups in the incidence of adverse events, serious adverse events, infections and infusion-related reactions. Conclusions: CT-P13 and RP have highly comparable efficacy (including PROs) and PK up to week 54. Over a 1-year period, CT-P13 was well tolerated and displayed a safety profile comparable to RP; no differences in immunogenicity were observed. © 2016 Park et al.
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Ankylosing spondylitis; ASAS; Biosimilar; Clinical trial; CT-P13; Efficacy; Immunogenicity; Infliximab; Pharmacokinetics; Safety antiinflammatory agent; ct p 13; infliximab; placebo; unclassified drug; antirheumatic agent; biosimilar agent; CT-P13; infliximab; monoclonal antibody; adolescent; aged; ankylosing spondylitis; area under the curve; Article; Bath ankylosing spondylitis disease activity index; Bath ankylosing spondylitis functional index; clinical assessment; comparative effectiveness; controlled study; disease severity; double blind procedure; drug blood level; drug efficacy; drug safety; female; headache; herpes virus infection; human; immunogenicity; infusion related reaction; latent tuberculosis; liver dysfunction; major clinical study; male; maximum plasma concentration; minimum plasma concentration; neutropenia; outcome assessment; randomized controlled trial; rash; remission; Short Form 36; sinusitis; treatment duration; tuberculosis; upper respiratory tract infection; urinary tract infection; adult; chemically induced; clinical trial; international cooperation; longitudinal study; metabolism; middle aged; multicenter study; neutropenia; self report; Spondylitis, Ankylosing; standards; toxic hepatitis; treatment outcome; young adult; Adolescent; Adult; Aged; Antibodies, Monoclonal; Antirheumatic Agents; Biosimilar Pharmaceuticals; Chemical and Drug Induced Liver Injury; Double-Blind Method; Female; Humans; Infliximab; Internationality; Longitudinal Studies; Male; Middle Aged; Neutropenia; Self Report; Spondylitis, Ankylosing; Treatment Outcome; Young Adult
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