In-clinic experience with half dose Etanercept Biosimilar in Indian patients with rheumatic diseases: A single center observational study

Synovial inflammation in rheumatic diseases leads to cartilage damage, bone erosions and subsequent joint destruction causing significant morbidity. Seronegative spondyloarthropathy or seropositive rheumatoid arthritis and their variants once diagnosed should be treated early to prevent the bony erosion. Delay of up to nine months in initiating Disease-Modifying Anti-rheumatic Drug (DMARD) definitely impacts clinical outcome several years later. During the last decade, introduction of biologics like TNF inhibitors have revolutionized the management of rheumatic diseases leading to early and prompt control over disease activity. One of the TNF inhibitors, Etanercept over the time has proven itself to be a reliable option for treatment of rheumatoid arthritis, spondyloarthropathy, psoriatic arthritis and other rheumatic diseases. Major drawback with biologics like Etanercept is their cost. Indian population differs substantially from western population in terms of height, weight, phenotype as well as genotype. Due to this difference in demographic profile and cost-affordability, many drugs have been used in low dose in Indian population. Etanercept can be a safe and effective option in rheumatic diseases even at half its recommended dose in countries like India where the average weight of people is less as compared to western population. Low dose also improves affordability, reduces risk of infections and may be, minimizes need for vaccination. In the modern era of biologicals, biosimilars have a huge potential to treat rheumatic diseases in India where affordability is a real challenge. This study was over 256 patients.