CARE Perspectives on the NOR-SWITCH Trial

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A Discussion between Dr. John Marshall and Dr. Brian Feagan

Biologic therapy has revolutionized the treatment of IBD and improved patient outcomes drastically. Many of the biologic therapies we routinely use are now or soon going off patent and competitive molecules, biosimilars, are now being introduced. Biosimilars have potential implications for our own practices but also for how we manage our pharmacy budgets and how we deliver health care in Canada.

The NOR-SWITCH trial was a randomized, double-blind trial studying a cohort of patients who were stable on the innovator biologic, infliximab (REMICADE®). Patients were randomized to either continue with infliximab or switch to a biosimilar version of infliximab (INFLECTRA™ in Canada). This was a cross specialty trial that included adult patients from a variety of diagnoses, including:  rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, Ulcerative Colitis (UC), Crohn’s Disease (CD) and chronic plaque psoriasis. Each group was followed for disease worsening as the primary endpoint measured by their respective disease activity indices. 

CARE Gastroenterology Faculty lead, Dr. John Marshall (McMaster University), sat down with Dr. Brian Feagan (Professor of Medicine at the University of Western) to critically assess this study and discuss how the results should be interpreted and applied in Canadian practice. 

The video interview from their conversation is also available below: