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Increase in use of biosimilar rituximab for NHL treatment Posted 21/09/2018

Researchers from the UK and US reported on how the treatment approach for non-Hodgkin lymphoma (NHL) patients has changed since the first biosimilars of rituximab were approved in the European Union five (EU5: France, Germany, Italy, Spain, UK) [1].

The first biosimilars of rituximab were approved in Europe to treat NHL in 2017 [2]. Truxima was approved by the European Commission (EC) in February 2017 [3]. Rixathon and Riximyo were approved by the EC in June 2017 [4]. Blitzima, Ritemvia and Rituzena (previously Tuxella) were approved by EC in July 2017 [5].

The authors used real-world data from Ipsos Healthcare’s Global Oncology Monitor to explore the prescription patterns of rituximab biosimilars in the EU5 to determine if biosimilars are favoured over brand-name versions for certain patient types.

The authors carried out an online multi-country, multicentre medical chart review study of NHL patients; 97 physicians provided de-identified data on 640 patients treated with anticancer drugs in France (117), Germany (73), Italy (117), Spain (136) and UK (197) between July and September 2017. Physicians were geographically representative and screened for treatment involvement levels and number of patients managed per month. Reporting on patients seen in consultation, they provided date of diagnosis, current and historic treatment, and reasons for prescribing/discontinuing anticancer drug treatment. Data on patients treated with and without a rituximab biosimilar were compared using descriptive statistics.

Of the 640 NHL patients studied, 77% were treated with a regimen that included brand-name rituximab. Prescribing of rituximab biosimilars was highest in Germany and the UK (14% and 13%, respectively). For recently-initiated patients in Germany and the UK, prescription of biosimilars increased towards the 2nd and 3rd lines of treatment (1L:11%; 2L:18%; 3L:30%). A profile comparison of German and UK patients treated with a rituximab biosimilar (27) versus brand-name rituximab (179) shows that the former is more likely to have: ECOG 0-1 (93% vs 82%); no comorbidities affecting cancer drug treatment (52% vs 31%); indolent vs aggressive status (70% vs 52%); and follicular lymphoma as sub-type of cancer (56% vs 35%).

These data were presented at the American Society of Clinical Oncology’s (ASCO) 2018 Annual Meeting, which was held on 1−5 June 2018 in Chicago, IL, USA.

The authors concluded that ‘physicians responsible for the drug treatment of NHL patients in EU5 have begun prescribing rituximab biosimilars. This seems to be more frequent after first line treatment, in fitter patients and for those with indolent disease and follicular lymphoma’.

Conflict of interest
The authors of the abstract [1] declared that there was no conflict of interest.

Editor’s comment
It should be noted that data of the study presented in this article was published as an abstract and presented at a conference. These data and conclusions should be considered as preliminary until published in a peer-reviewed journal.

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Biosimilars of rituximab

References
1.  Franceschetti A, Caldeira R. Treatment approach for non-Hodgkin lymphoma patients since first biosimilars of rituximab approved in EU5. American Society of Clinical Oncology (ASCO) 2018 Annual Meeting; 1-5 June 2018; Chicago IL, USA.
2.  GaBI Online - Generics and Biosimilars Initiative. Biosimilars of rituximab [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Sep 21]. Available from: www.gabionline.net/Biosimilars/General/Biosimilars-of-rituximab
3.  GaBI Online - Generics and Biosimilars Initiative. EC approval for first cancer biosimilar Truxima [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Sep 21]. Available from: www.gabionline.net/Biosimilars/News/EC-approval-for-first-cancer-biosimilar-Truxima
4.  GaBI Online - Generics and Biosimilars Initiative. EC approval for rituximab biosimilar Rixathon [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Sep 21]. Available from: www.gabionline.net/Biosimilars/News/EC-approval-for-rituximab-biosimilar-Rixathon#
5.  GaBI Online - Generics and Biosimilars Initiative. EC approval for three rituximab biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2018 Sep 21]. Available from: www.gabionline.net/Biosimilars/News/EC-approval-for-three-rituximab-biosimilars

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