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We read with interest the recently published recommendations for the use of biosimilars in rheumatology practice.1 However, we have some concerns regarding recommendation 6 on the efficacy and safety of switching from the originator biologic to the respective biosimilar. Considering the strong impact of the European League Against Rheumatism recommendations on real-life clinical decisions, such recommendation seems not sufficiently supported by the evidence because available data do not allow to draw definitive conclusion on the switching strategy. To date, the efficacy and safety of infliximab and etanercept biosimilars in substitution of the bio-originators have been assessed in four long-term extension reports following the blinded phase …
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