A descriptive analysis of real-world treatment patterns of innovator (Remicade^®) and biosimilar infliximab in an infliximab-naïve Turkish population

Figures & data

Table 1 Baseline descriptive characteristics for patients with IFX or CT-P13 use

Covariates	RA patients (N=779)			IBD patients (N=581)
	IFX cohort (N=575)	CT-P13 cohort (N=204)		IFX cohort (N=504)	CT-P13 cohort (N=77)
			P-value			P-value
Age (years), mean ± SD	42±12.4	43.3±11.8	NS	38.2±13.0	41.4±12.8	0.046
Age group, N (%)
18–30	116 (20.2%)	31 (15.2%)	NS	156 (31.0%)	18 (23.4%)	NS
31–64	434 (75.5%)	168 (82.4%)	0.044	328 (65.1%)	56 (72.7%)	NS
≥65	25 (4.3%)	5 (2.5%)	NS	20 (4.0%)	3 (3.9%)	NS
Sex, N (%)
Male	264 (45.9%)	84 (41.2%)	NS	290 (57.5%)	40 (51.9%)	NS
Female	311 (54.1%)	120 (58.8%)	NS	214 (42.5%)	37 (48.1%)	NS
Geographic region (Turkey), N (%)
East Anatolia	39 (6.8%)	17 (8.3%)	NS	14 (2.8%)	5 (6.5%)	NS
Southeastern Anatolia	50 (8.7%)	15 (7.4%)	NS	18 (3.6%)	5 (6.5%)	NS
Marmara	242 (42.1%)	61 (29.9%)	0.002	261 (51.8%)	23 (29.95%)	<0.001
Aegean	48 (8.3%)	16 (7.8%)	NS	65 (12.9%)	5 (6.5%)	NS
Mediterranean	59 (10.3%)	33 (16.2%)	0.025	50 (9.9%)	11 (14.3%)	NS
Black sea	50 (8.7%)	20 (9.8%)	NS	27(5.4%)	16 (20.8%)	<0.001
Central Anatolia	87 (15.1%)	42 (20.6%)	NS	69 (13.7%)	12 (15.6%)	NS
Pre-index comorbidity index, Mean ± SD
Charlson comorbidity index score	1.3±1.1	1.3±1.0	NS	0.7±0.9	0.7±0.8	NS
Individual comorbidities, N (%)
Gastrointestinal ulcer & GERD	157 (27.3%)	56 (27.5%)	NS	106 (21.0%)	19 (24.7%)	NS
Hypertension	135 (23.5%)	54 (26.5%)	NS	68 (13.5%)	12 (15.6%)	NS
Chronic pulmonary disease	66 (11.5%)	35 (17.2%)	0.038	49 (9.7%)	6 (7.8%)	NS
Depression	63 (11.0%)	27 (13.2%)	NS	5 (9.9%)	9 (11.7%)	NS
Connective tissue disease (without RA)	38 (6.6%)	2 (1.0%)	0.002	57 (11.3%)	15 (19.5%)	0.042
Diabetes mellitus (type 1 & 2)	38 (6.1%)	10 (4.9%)	NS	24 (4.8%)	4 (5.2%)	NS
Mild liver disease	38 (5.4%)	4 (2.0%)	0.042	49 (9.7%)	4 (5.2%)	NS
Proportion of IBD patients, N (%)
Ulcerative colitis (UC) diagnosis				280 (55.6%)	46 (59.7%)	NS
Crohn’s disease (CD) diagnosis				335 (66.5%)	41 (53.2%)	0.024
Both diagnoses (UC & CD)				124 (24.6%)	12 (15.6%)	NS

Abbreviations: GERD, gastroesophageal reflux disease; IBD, inflammatory bowel disease; IFX, infliximab; NS, not significant; PSA, psoriatic arthritis; RA, rheumatoid arthritis; UC, ulcerative colitis; CD, Crohn’s disease.

Table 2 Baseline medication and procedures for patients initiating IFX and CT-P13 use

	RA patients (N=779)
	IFX cohort (N=575)	CT-P13 cohort (N=204)
	N (%)	N (%)	P-value
Baseline biologic use
Patients with biologic use prior to initiating IFX or CT-P13	160 (27.8%)	64 (31.4%)	NS
Baseline RA-related therapies and DMARDs
NSAIDs	510 (88.7%)	191 (93.6%)	0.044
Corticosteroids	454 (79.0%)	169 (82.8%)	NS
Methotrexate/methotrexate sodium	188 (32.7%)	81 (39.7%)	NS
Sulfasalazine	182 (31.7%)	102 (50.0%)	<0.001
Hydroxychloroquine	97 (16.9%)	53 (26.0%)	0.005
Azathioprine	88 (15.3%)	16 (7.8%)	0.007
Leflunomide	79 (13.7%)	35 (17.2%)	NS
Cyclophosphamide	8 (1.4%)	0 (0.0%)	NS
	IBD patients (N=581)
	IFX cohort (N=504)	CT-P13 cohort (N=77)
Baseline biologic use
Patients with biologic use prior to initiating IFX or CT-P13	106 (21.0%)	14 (18.2%)	NS
Baseline IBD-related therapies
Aminosalicylic acid derivatives	393 (78.0%)	67 (87.0%)	NS
Antibiotics	343 (68.1%)	54 (70.1%)	NS
Immunosuppressant	336 (66.7%)	48 (62.3%)	NS
Corticosteroids	328 (65.1%)	51 (66.2%)	NS
Antidiarrheal	65 (12.9%)	6 (7.8%)	NS
Baseline IBD-related procedures
Colonoscopy	334 (66.3%)	43 (55.8%)	NS
Sigmoidoscopy	58 (11.5%)	5 (6.5%)	NS
Esophagogastroduodenoscopy	30 (6.0%)	9 (11.7%)	NS
Fistulography	3 (0.6%)	0 (0.0%)	NS
Colectomy	2 (0.4%)	0 (0.0%)	NS
Stricturoplasty	0 (0.0%)	0 (0.0%)	NA
# Patients without IBD-related therapies or procedures	6 (1.2%)	2 (2.6%)	NS

Abbreviations: DMARDs, disease-modifying antirheumatic drugs; IBD, inflammatory bowel disease; IFX, infliximab; NA, not available; NS, not significant; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis.

Table 3 Follow-up concomitant diseases and disease-related medication use in patients who initiated IFX or CT-P13

	RA patients (N=779)			IBD patients (N=581)
	IFX cohort (N=575)	CT-PI3 cohort (N=204)		IFX cohort (N=504)	CT-PI3 cohort (N=77)
			P-value			P-value
Average length of follow-up period (months) mean ± SD	16.5±2.3	15.5±2	<0.001	13.2±4.1	11.6±3.7	0.001
Patients with concomitant disease N (%)
PsA or psoriasis	100 (17.4%)	31 (15.2%)	NS	23 (4.6%)	11 (14.3%)	<0.001
Ankylosing spondylitis	288 (50.1%)	131 (64.2%)	<0.001	104 (20.6%)	37 (48.1%)	<0.001
Crohn’s disease	49 (8.5%)	9 (4.4%)	NS
Ulcerative colitis	38 (6.6%)	6 (2.9%)	NS
Rheumatoid arthritis				89 (17.7%)	21 (27.3%)	0.045
Gastrointestinal bleeding				3 (0.6%)	0 (0%)	NS
Fistula				11 (2.2%)	0 (0%)	NS
Concomitant DMARDs and RA-related treatment N (%)
NSAIDs	488 (84.9%)	187 (91.7%)	0.014
Corticosteroids	461 (80.2%)	177 (86.8%)	0.036
Methotrexate/methotrexate sodium	170 (29.6%)	74 (36.3%)	NS
Sulfasalazine	91 (15.8%)	49 (24.0%)	0.009
Azathioprine	90 (15.7%)	13 (6.4%)	<0.001
Hydroxychloroquine	66 (11.5%)	30 (14.7%)	NS
Leflunomide	65 (11.3%)	27 (13.2%)	NS
Tofacitinib	2 9 (0.3%)	3 (1.5%)	NS
IBD-related therapies N(%)
Immunosuppressant				327 (64.9%)	46 (59.7%)	NS
Aminosalicylic acid derivatives				323 (64.1%)	56 (72.7%)	NS
Corticosteroids				323 (64.1%)	57 (74.0%)	NS
Antibiotics				264 (52.4%)	36 (46.8%)	NS
Antidiarrheal				56 (11.1%)	3 (3.9%)	NS

Abbreviations: DMARD, disease-modifying anti-rheumatic drug; IBD, inflammatory bowel disease; IFX, infliximab; NS, not significant; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis.

Figure 1 Proportion of IFX or CT-P13 cohort with index therapy discontinuation.

Abbreviations: IBD, inflammatory bowel disease; IFX, infliximab; RA, rheumatoid arthritis.

Figure 2 Proportion of RA and IBD switchers selecting alternative therapies.

Abbreviations: IBD, inflammatory bowel disease; IFX, infliximab; RA, rheumatoid arthritis.

Figure 3 Geographical distribution of first switch by study cohort.

Note: *P-value<0.05.
Abbreviations: IBD, inflammatory bowel diseases; IFX, infliximab; RA, rheumatoid arthritis.