OBJECTIVES:

Till May 2018, two biosimilars of the reference biologic infliximab have been used for the treatment of inflammatory bowel disease (IBD). The aim of this study was to evaluate the clinical efficacy of infliximab biosimilars in patients with IBD who were either on maintenance treatment with biosimilar infliximab or were switched to biosimilar infliximab therapy.

METHODS:

A systematic review of relevant research from electronic databases was conducted. The outcomes studied were the pooled rates of clinical response or remission overall in patients following short and medium and long term treatment of Crohn’s disease (CD) or ulcerative colitis (UC), as well as for each treatment-duration separately. The analysis was carried out with Open Meta-analyst software.

RESULTS:

A total of 16 observational studies from 2015 to 2018 fulfilled the inclusion criteria. For the short and medium and long term treatments overall: The pooled rates of i) clinical response among CD and UC patients were 0.780 (95% confidence interval (CI) = 0.698-0.862) and 0.760 (95%CI = 0.661-0.859), respectively, and ii) clinical remission among CD and UC patients were 0.680 (95%CI = 0.615-0.745) and 0.592 (95%CI = 0.507-0.677) respectively.

While, for the subgroup previously treated with reference infliximab, the pooled rates of i) sustained clinical response among CD and UC patients were 0.850 (95%CI = 0.752–0.948) and 0.927 (95%CI = 0.824–1.029), respectively, and ii) sustained clinical remission among CD and UC patients were 0.755 (95%CI = 0.720–0.831) and 0.835 (95%CI = 0.771–0.899), respectively.

The pooled rates of clinical response and remission when analysed for each treatment-duration separately were found to vary only slightly from the overall rates.

CONCLUSIONS:

The efficacy of infliximab biosimilars as determined based on clinical response or remission was favorable in IBD patients, on either maintenance treatment or switched to biosimilar infliximab.