P03 Effectiveness and tolerability of Benepali in patients switched from Enbrel with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthropathy

Background Benepali (SB4) is an etanercept biosimilar licensed for rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthropathy (AS) and is cheaper than Enbrel (ETN). We aimed to evaluate the effectiveness and tolerability of switching from ETN to SB4 and costs saved. Methods All patients on ETN were identified from pharmacy records and reviewed by consultants for clinical suitability to switch to SB4. Letters informing patients of the proposed switch were sent and replies collated. Patients were switched when prescriptions were due for renewal. Switching started in June 2018 and patients were prospectively followed at 3 and 6 months after switching. Anonymised demographic and clinical data were collected from patient records. DAS28 was calculated for RA and PsA due to availability of score components from patient records. The difference between disease activity scores prior to the switch, 3 months, and 6 months after switching was analysed using the Wilcoxon signed-rank test. Results 113 patients were prescribed ETN and 17 patients were clinically unsuitable to switch. Of the remaining 96 patients, 6 declined switching and 7 stopped ETN before switching. The remaining 83 patients were switched from ETN to SB4 over a year and analysed (Table 1). Comparing measures of disease activity prior to switching versus 3 months or 6 months of follow-up on SB4, there were no statistically significant differences in disease activity for patients with RA (Table). Missing data for PsA and AS precluded statistical comparisons. 5 patients switched back to ETN due to subjective worsening of joint symptoms. 3 patients switched back to ETN due to adverse effects (infections, dizziness and nausea, unknown). 1 patient switched from SB4 to abatacept due to high disease activity. 1 patient stopped SB4 due to incident lung cancer. Conclusion SB4 was generally well tolerated with a retention rate of 88% (73/83) over 6 months of follow-up. In RA there was no significant difference in patients’ disease activity when switching from ETN to SB4, at 3 or 6 months of follow-up. Assuming all 73 switched patients remained on SB4 for a year, this would equate to £56,000 cost savings per year. Disclosures B. Yeo None. S. Dyball None. A. Low None.