Study Supports Adalimumab Biosimilar Interchangeability for Patients with Psoriasis

New findings support adalimumab biosimilar interchangeability and the practice of non-medical switches between such biosimilars for patients with psoriasis, with the most commonly registered treatment discontinuation reason being a loss of effect.1

These findings represent the conclusion of research conducted by such investigators as Ole Krogh-Jensen, from the Department of Dermatology and Allergy at Copenhagen University Hospital in Denmark. Krogh-Jensen and colleagues highlighted that, while previous research has pointed to a lack of effect on treatment persistence with transitioning from an originator biologic to a biosimilar, there had been limited data on the implications of undergoing multiple switches between various biosimilars.2

The investigative team, based in Denmark, highlighted that the country's prescribing policies are based on cost, with requirements pointing to mandatory non-medical switching between adalimumab biosimilars whenever a lower-priced product is determined to be the preferred option.

“Since November 2018, several switches have occurred, from originator to GP2017 (Hyrimoz) to ABP 501 (Amgevita), back to GP2017 (Hyrimoz),” Krogh-Jensen and coauthors wrote.1 “This setup gives a distinctive real-world setting for assessing the consequences of multiple non-medical switches between biosimilars.”

Individuals deemed eligible to be participants included

those with diagnoses of psoriasis at Copenhagen University Hospital—Herlev and Gentofte who had also been given an adalimumab therapeutic for at least 6 months before a required switch. The investigative team grouped the subjects based on the initial adalimumab product implemented.

Specifically, they separated them into the originator cohort (up to 3 switches), those in the GP2017 cohort (up to 2 switches), and the ABP 501 cohort (only a single switch). The main outcome that the team assessed in these participants was discontinuation of treatment within 6 months after the non-medical switch.

There were 182 patients in total who Krogh-Jensen et al involved in their analysis, with 61 individuals in the originator arm, 67 in the GP2017 arm, and 54 in the ABP 501 arm. They noted that 68.1% were male and that the subjects had a mean age of 48.3 years (±14.8).

Among all of the study cohorts, it was reported that therapy discontinuation took place within 6 months after the switch ranged from 0% - 8.2%. The highest rate of discontinuiation that the investigative team observed took place following the initial switch from the originator to GP2017.

They added that the lowest rate had been seen following the third switch in the originator cohort, specifically from ABP 501 to GP2017. Among the reasons given for cessation, the loss of therapeutic effect was the most commonly reported one. The investigators highlighted that 2 subjects stopped treatment as a result of adverse events, though subsequent remission was attained upon resuming the originator biologic.

Prior data on a variety of biosimilar switches were noted by the team to be sparse. A phase 3 clinical trial they pointed to, looking at switches to GP2017, indicated that multiple switches between the originator and GP2017 did not significantly raise patients' risk of psoriasis flares between Weeks 17 - 51 when comparing individuals who shifted between products with those who remained on the same drug.

Aligning with certain other research highlighted by the coauthors, a lack of elevated risk of therapy discontinuation was observed with multiple non-medical switches compared to the expected discontinuation rate for those who maintained a consistent treatment regimen. Krogh-Jensen and colleagues' data, suggesting that the initial change from originator to GP2017 carries the highest discontinuation risk, could result from increased uncertainty or hesitancy among individuals when first switching from an originator to a biosimilar.

Variations in injection devices, excipients, or formulation volumes may result in reactions at injection sites. The investigative team suggest that while this conclusion was not observed in this analysis specifically, have been attributed to 37% of adverse events related to non-medical switching in other research.

“In conclusion, this study's findings support the notion of biosimilar interchangeability and the practice of non-medical switches between adalimumab products,” the investigators concluded.1

References

1. Krogh-Jensen O, Schwarz CW, Kaur-Knudsen D, et al (2025). Real-world experience of multiple switches between adalimumab biosimilars in patients with psoriasis. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.20727.

2. Cohen AD, Vender R, Naldi L, Kalb RE, Torres T, Rajagopalan M, et al. Biosimilars for the treatment of patients with psoriasis: a consensus statement from the biosimilar working Group of the International Psoriasis Council. JAAD Int. 2020; 1(2): 224–230.