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Patients' perspectives after switching from infliximab to a biosimilar have yet to be assessed. To assess patients' perspectives in a prospective manner after switching from infliximab to CT-P13. 113 consecutive patients with inflammatory bowel disease (IBD) on maintenance therapy with infliximab were switched to CT-P13. Patients' perspectives were assessed by questionnaires, including the Beliefs about Medicines Questionnaire (BMQ) and FACIT-F (questionnaire regarding fatigue), and patient-reported outcomes (IBD disability index) at the inclusion and after the fourth CT-P13 infusion. After one year, the patients' perspectives did not change after the switch according to BMQ-general, BMQ-specific necessity and BMQ-specific concerns subscales. No difference was observed in the mean IBD-DI score, while a significant improvement in fatigue was observed according to the FACIT-F questionnaire. Patients' concerns were raised about the use of biosimilars and the risks of switching with a significant improvement after switching (65% vs. 42%, respectively, p = 0.01). Fourteen (12.4%) patients experienced loss of response to CT-P13, including 12 with restoration of steroid-free clinical remission after CT-P13 dose optimization. Although some concerns were reported, no difference was observed in patients' perspectives after switching from infliximab to CT-P13. [ABSTRACT FROM AUTHOR]

Résumé: Les manifestations extra-intestinales des maladies inflammatoires chroniques de l'intestin (MICI) sont fréquentes et polymorphes, dominées par les atteintes ostéoarticulaires et cutanéo-muqueuses. Ces manifestations ont un impact significatif sur la qualité de vie des patients et sur les choix thérapeutiques du clinicien. Les manifestations extra-intestinales associées aux MICI surviennent de façon plus fréquente au cours de la maladie de Crohn par rapport à la rectocolite hémorragique. La plupart des manifestations extradigestives évoluent de façon synchrone avec l'activité de la MICI. Un certain nombre peut néanmoins évoluer de façon dissociée, nécessitant des prises en charge concomitantes. Cette distinction souligne la physiopathologie complexe de ces manifestations qui peuvent faire intervenir d'un côté le déclenchement d'une réponse immunitaire au-delà du tube digestif via une translocation d'épitopes bactériens et de l'autre, une communauté de facteurs génétiques et environnementaux partagés par différentes entités inflammatoires. Dans cette revue, nous aborderons les aspects cliniques des manifestations extra-intestinales et ses conséquences sur la prise en charge des MICI. Patients with Inflammatory Bowel Disease (IBD) experience at least one extra-intestinal manifestation (EIM) in up to 50% of the cases. EIM have a negative impact on the patient's quality of life and may interfere with treatment decision-making. EIMs are more common in CD than UC and there is a broad range of manifestations. The most prevalent EIMs in IBD are arthralgia/arthritis and skin manifestations. Most EIMs run in parallel with the intestinal disease activity but they may also have distinct course requiring multidisciplinary management. The pathogenesis of EIM in IBD is not univocal, combining a trigger immune response at the extraintestinal site due to translocation of bacterial epitopes and a shared community of genetic and environmental factors. This review focuses on the clinical features of EIM and consequences on the management of patients with IBD. [ABSTRACT FROM AUTHOR]