Comparative evaluation of efficacy, pharmacodynamics, and safety of Hetero’s adalimumab (Mabura®, Hetero Biopharma Ltd.) and reference adalimumab (Humira®, Abbvie Inc.) in patients with active rheumatoid arthritis on concomitant methotrexate therapy

Abstract

Background Our study aimed to compare efficacy and safety of Hetero’s adalimumab (Mabura®, Hetero Biopharma Limited) versus reference adalimumab (Humira®, Abbvie Inc.) in Indian patients with active rheumatoid arthritis (RA) concomitant on methotrexate (MTX) therapy. Methods Patients (n = 168) were randomized (2:1) to receive either test or reference product for 24 weeks with concomitant MTX. Proportion of patients achieving American College of Rheumatology 20 (ACR20) criteria at week 12 was the primary endpoint. Changes in Disease Activity Score of 28 joints–C-reactive protein (DAS28-CRP), Health Assessment Questionnaire–Disability Index (HAQ-DI), and patients achieving ACR20 at week 24, ACR50/70 at weeks 12 and 24 were secondary endpoints. Results Patients achieving ACR20 responses with test (96.43%) were similar to reference (96.43%) in intention-to-treat (ITT) analysis at week 12. Proportional difference (PD) between groups (PD [95% CI] 0.0 [− 6.0, 6.0], p = 1.000) for ACR20 at week 12 for ITT analysis showed lower limit of the two-sided 95% CI was above the pre-specified noninferiority margin of − 15%. Similar trend in PP analysis (PD [95% CI] 0.0 [− 0.03, 0.07], p = 1.000), confirmed therapeutic equivalence. No significant difference was noted between arms for patients attaining ACR20 at week 24 and ACR50/70 at weeks 12 and 24 (all p > 0.05). DAS28-CRP and HAQ-DI were similar between groups. Total of 54 patients reported 88 AEs during the study. Out of these, 60 AEs were reported in 34 patients with Hetero-Adalimumab and 28 AEs were reported in 20 patients with Reference-Adalimumab. Total two patients, one in each group reported two serious adverse events (Sinusitis and Viral infection) during the study and resolved completely. No deaths and no life threatening AEs were reported. Conclusion Results demonstrated Hetero’s adalimumab is as effective and well tolerated as reference adalimumab in patients with active RA concomitantly on MTX therapy. Trial registration CTRI/2016/04/006884, Registered on 28/04/2016.

Comparison of Adalimumab to Other Targeted Therapies in Rheumatoid Arthritis: Results from Systematic Literature Review and Meta-Analysis

“…Among studies whose reference treatment was combination therapy of adalimumab originator and methotrexate (MTX), four compared adalimumab to its biosimilars [ 25 , 26 , 27 , 28 ], two studies compared adalimumab to tofacitinib [ 29 , 30 ] and one each for adalimumab compared to abatacept [ 31 ], certolizumab pegol [ 32 ], baricitinib [ 33 ], upadacitinib [ 34 ] and filgotinib [ 35 ]. Among studies whose reference treatment was adalimumab originator monotherapy, three studies compared adalimumab originator to its biosimilar [ 36 , 37 , 38 ], and one each for tocilizumab [ 39 ] and sarilumab [ 40 ], respectively.…”

Rituximab, a Safer Option for Rheumatoid Arthritis: A Comparison of the Reported Adverse Events of Approved Monoclonal Antibodies

“…No deaths have been reported during the study. 40 Cases of tocilizumab-induced pancreatitis and rituximabinduced psoriasis and progressive multifocal leukoencephalopathy have been previously reported in the literature. [41][42][43] In addition, our systematic analysis has numerous limitations, such that available data are scarce in terms of sample size and follow-up time.…”

Biologic Drugs for Rheumatoid Arthritis in the Context of Biosimilars, Genetics, Epigenetics and COVID-19 Treatment

“…Another trial showed that there were no differences in immunogenicity, efficacy or safety even after one or two drug switches between biosimilar and biooryginator [ 60 ]. There was no increase in adverse events (AEs) in patients with ADA biosimilar and concomitant MTX therapy comparing to Humira and MTX treatment [ 61 ].…”