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Objectives The primary objective of this study was to assess the stressful life events preceding the onset of symptoms in RA. The secondary objectives were to assess how early RA patients perceive stress and cope with stressors. Methods A case–control study was performed, comparing patients recently diagnosed with RA to age- and gender-matched control subjects recently hospitalized for an unplanned surgical procedure not known to be influenced by stress. The Social Readjustment Rating Scale assessed the cumulative stress induced by stressful life events in the year preceding the onset of symptoms. Coping strategies, stress and anxiety symptoms were evaluated using validated psychological scales. Results Seventy-six subjects were included in each group. The mean Social Readjustment Rating Scale score was twice as high in cases compared with controls [respectively, 167.0 (172.5) vs 83.3 (124.4), P Conclusion Patients with early RA reported more life events in the year preceding the onset of symptoms than controls. Gender specificities were found with a significant association between cumulative stress and RA only in women.

Objective To explore acceptance and retention rate of biosimilar CT-P13 after switching from originator infliximab (OI) in patients with various rheumatic diseases. Methods Patients with stable rheumatoid arthritis (RA), ankylosing spondylitis (AS) or psoriatic arthritis (PsA) under OI were proposed to switch to CT-P13 at the same regimen. A prospective cohort of infliximab-naive patients beginning CT-P13 and a retrospective cohort of patients treated with OI were used as controls. The primary outcome was to evaluate the retention rate of CT-P13. Secondary outcomes were the switch acceptance rate, reasons of failure and safety. Results Switch was proposed to 100 patients and accepted by 89 of them (63 AS, 12 PsA and 14 RA). After a median follow-up of 33 weeks, 72% of patients were still treated with CT-P13. This retention rate was significantly lower than the one found in our retrospective and prospective control cohorts: 88% and 90% respectively (P-value = 0.0002). Within patients who asked to be reswitched to OI, 13/25 (52%) presented clinical disease activity, one developed serum sickness and 11 (44%) presented no objective activity. A subanalysis excluding these 11 patients abrogated difference in retention rates between the 3 cohorts (P-value = 0.453). After reswitching to OI, patients without objective disease activity claimed to recover original efficacy. Conclusions Retention rate was lower after switching from OI to CT-P13 compared to our control cohorts. However, this difference faded after excluding patients without objective clinical activity, suggesting a reluctance of patients to the switch and a negative perception of the biosimilar.

Resume Objectifs Etudier l’acceptabilite et le taux de maintien de l’infliximab biosimilaire CT-P13 (Inflectra©) apres switch a partir de l’infliximab original (IO) chez des patients atteints de rhumatismes inflammatoires. Methodes Il a ete propose a des patients atteints de polyarthrite rhumatoide (PR), de spondylarthrite ankylosante (SA) ou de rhumatisme psoriasique (RhPso) controles sous IO, un switch pour le CT-P13 en poursuivant le meme schema therapeutique. Une cohorte prospective de patients naifs d’infliximab debutant le CT-P13 et une cohorte historique de patients traites par IO ont ete utilisees comme groupes temoins. L’objectif principal etait d’etudier le taux de maintien du CT-P13. Les objectifs secondaires etaient l’etude de l’acceptabilite, des raisons d’echec du switch et de la tolerance. Resultats Le switch a ete propose a 100 patients et accepte par 89 d’entre eux (63 SA, 12 RhPso et 14 PR). Apres un suivi median de 33 semaines, 72 % des patients etaient toujours traites par CT-P13. Ce taux de maintien etait significativement plus faible que celui retrouve dans les cohortes temoins historique et prospective : 88 % et 90 % respectivement (p = 0,0002). Parmi les patients demandant un retour a l’IO, 13/25 (52 %) presentaient une activite clinique de leur maladie, un patient a presente une maladie serique et 11 (44 %) ne presentaient pas d’activite objective. Une analyse excluant ces 11 patients faisait disparaitre la difference de taux de maintien entre les 3 cohortes (p = 0,453). Apres retour a l’IO, les patients sans activite clinique objective retrouvaient tous leur etat anterieur. Conclusion Le taux de maintien etait significativement plus faible apres le switch de l’IO vers le CT-P13 par rapport aux cohortes temoins. Cependant, cette difference disparaissait apres exclusion des patients sans activite clinique objective, suggerant une reticence des patients pour le switch et une perception negative du biosimilaire.

International audience; Objective : To study acceptance rate and factors influencing acceptance of the switch from originator etanercept (Enbrel©) to biosimilar etanercept (SB4, Bénépali©) in patients with rheumatic disease.Methods : Patients with a well-controlled rheumatic disease consulting in our rheumatology department were offered the switch for SB4. After oral and written information concerning biosimilar, free choice to accept the switch was left to the patients. The main outcome was primary switch acceptance rate defined by switch acceptance during the initial consult. Real switch adherence, socio-cultural factors and beliefs influencing switch acceptance rate were retrieved during a telephonic interview at distance from the consultation.Results : Fifty-two patients were eligible for the switch: 32 (62%) with spondyloarthritis and 20 (38%) with rheumatoid arthritis. The primary acceptance rate was 92% (48/52). Patients refusing the switch were more likely to report a bad opinion on generic drugs (100% vs 11%, p

To date, all available data regarding the switch from bio-originator to its biosimilar are reassuring, and the switch has been recommended as a shared patient–physician decision in recent consensus-based recommendations.1 In particular, the Norway's infliximab switching study (NOR-SWITCH study), a 52-week randomised double-blind trial, strongly supports the efficacy and safety of the switch from originator infliximab (OI) to its biosimilar CT-P13 in patients with a stable disease.2 However, long-term follow-up data are required to confirm the efficacy and safety of the switch. In a previous real-life study, we demonstrated a high acceptance of 89% (89/100) and a 72% (64/89) retention rate after a median follow-up of 33 weeks in a cohort of patients with stable rheumatic diseases switched from OI to CT-P13.3 This retention rate was lower compared with two control cohorts: a historic cohort of 82 patients treated with OI in 2013, and …