Switching from an originator to a biosimilar considered safe and effective in treating psoriasis

Based on complementary real-world evidence, psoriasis patients were able to safely and effectively switch to biosimilar therapies, particularly adalimumab, infliximab, and etanercept, according to Journal of Dermatological Treatment.

“A barrier to the use of biosimilars in clinical practice is the lack of trust of physicians and patients,” explained the researchers. “Both physicians and patients report preferences for reference products over biosimilars due to concerns about patient mental health, treatment efficacy, and patient safety. Provider hesitancy may stem from concerns that the development of biosimilars is not subject to the same scrutiny as novel biologics.”

Biosimilars offer a cost-effective alternative and increase treatment availability for patients. Researchers evaluated data from real-world studies in patients with psoriasis on biosimilars from biologics in this literature review using PubMed and Google Scholar search. Key words “switching between biosimilars in psoriasis,” “switching from adalimumab originator to biosimilar in psoriasis,” “switching from etanercept originator to biosimilar in psoriasis,” “switching from infliximab originator to biosimilar,” and “switching to biosimilar in psoriasis” factor (TNF) inhibitor biosimilars in psoriasis .”

Finally, 7 articles on infliximab biosimilars, 6 articles on etanercept biosimilars, and 5 articles on biosimilars were included. Safety and efficacy profiles were comparable in those switching from originators to biosimilars.

Among the 5 observational adalimumab studies, similar efficacy regarding skin disease control was observed after switching to biosimilar therapy. Two of the 3 studies analyzing articular disease showed no loss in disease control. An increase in mild adverse events (AEs) was reported in 2 of the 5 studies.

Observational etanercept biosimilar studies also observed efficacy in the treatment of skin and articular disease, which was comparable between biosimilars or after switching from the reference product to biosimilar therapy. AEs were more prevalent in 1 study after the switch, although there was no control cohort to compare results.

For patients in the infliximab study (6 observations and 1 case report), there was comparable efficacy for the treatment of skin and articular disease between infliximab biosimilar or those switching from infliximab to biosimilar therapy. One study reported an increased number of mild AEs; However, no statistical analysis was performed.

Study limitations included single-arm designs without controls, duration of follow-up, and sample sizes. In addition, the studies did not examine immunogenicity after switching from the reference product to the biosimilar. Differences in treatment adherence and how patients handle biologic drug products are more likely to cause more variation in outcomes than differences between the innovator product and the biosimilar.

“Understanding that biologics cannot be duplicated (not even from batch to batch of invention) makes it clear that patients are already switching from one biologic to another, even when they think they are taking the same product,” the researchers concluded. “Doing so appears safe and effective, and the available real-world evidence suggests that patients can also safely and effectively switch to biosimilar therapies for the treatment of (non-medical) psoriasis.”


Ruda RC, Kelly KA, Feldman SR. Real-world outcomes after switching from anti-TNF reference products to biosimilars for the treatment of psoriasis. J Dermatol Therap. 2023; 34(1): 2140569. doi:10.1080/09546634.2022.2140569

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