TY - JOUR T1 - Mandatory, cost-driven switching from originator etanercept to its biosimilar SB4: possible fallout on non-medical switching JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - e13 LP - e13 DO - 10.1136/annrheumdis-2018-214757 VL - 79 IS - 2 AU - Fabrizio Cantini AU - Maurizio Benucci Y1 - 2020/02/01 UR - http://ard.bmj.com/content/79/2/e13.abstract N2 - We read with great interest the recently published results from DANBIO registry on switching from originator etanercept (ETA) to the biosimilar SB4.1 The study includes a really impressive number of patients who underwent mandatory switching to SB4, and at first glance the results show a good evidence of efficacy and safety of the procedure. However, in our opinion, how these results may be applied on non-medical switching strategy is rather questionable. A careful reading of the paper raises several concerns related to the demographic and clinical characteristics of switchers and non-switchers, and to the timing of clinical evaluations that may generate misleading biases.First, switchers had longer previous ETA treatment duration and fewer previous bDMARDs compared with non-switchers suggesting a less severe disease. This seems to be confirmed by the baseline lower disease activity both … ER -