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CIBRN Poll #5: Do you agree with the 2019 Update of the American College of Rheumatology (ACR) Recommendations on the Treatment of Ankylosing Spondylitis (AS) that says: “In adults with stable AS receiving an originator TNFi, we strongly recommend continuing treatment with the originator TNFi over mandated switching to its biosimilar.”
RATIONALE: While the efficacy of originator and biosimilar TNFi is comparable, and although either could be chosen to initiate new courses of TNFi treatment, it was the opinion of the panel to recommend against mandated switching to a biosimilar during the course of treatment, in the absence of evidence of interchangeability. Medication changes can increase the risk of destabilizing a patient’s condition, and the panel judged that additional data were needed to understand the frequency of potential problems and concerns associated with switching patients who were stable on an originator TNFi to its biosimilar. Given these concerns, the panel judged that there should be a compelling rationale for switching medications, particularly in light of the marginal cost savings apparent for US patients.
Full text of update available here: https://onlinelibrary.wiley.com/doi/full/10.1002/acr.24025
Do you agree with the ACR’s recommendation on the treatment of AS?
- I agree because of the limited evidence on biosimilar switching in AS.
- I agree because of the limited evidence on biosimilar switching in general in rheumatic, dermatologic and GI conditions.
- I agree because of the limited cost savings anticipated from biosimilar switching in the North American context.
- I disagree with this recommendation.