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Comparative evaluation of efficacy, pharmacodynamics, and safety of Hetero’s adalimumab (Mabura®, Hetero Biopharma Ltd.) and reference adalimumab (Humira®, Abbvie Inc.) in patients with active rheumatoid arthritis on concomitant methotrexate therapy

  • Sinha, Shubhadeep1
  • Ghosh, Biswadip2
  • Bandyopadhyay, Syamasis3
  • Fatima, Firdaus4
  • Bandi, Vamsi Krishna1
  • Thakur, Pankaj1
  • Reddy, Bala1
  • Chary, Sreenivasa1
  • Talluri, Leela1
  • Gupta, Ajay5
  • Kale, Amit Ramchandra6
  • Gupta, Anil Kumar7
  • P, Ashok Kumar8
  • Reddy, Diwakar9
  • Mohammed, Younus10
  • Shekar, Soma11
  • T, Sudheer12
  • Goni, Vijay G.13
  • Sharma, Vishnu14
  • Yeligod, Vishwanath15
  • 1 Hetero Biopharma Limited, Hyderabad, India , Hyderabad (India)
  • 2 Institute of Post Graduate Medical Education & Research & SSKM Hospital, 244, AJC Bose Road, Kolkata, West Bengal, 700020, India , Kolkata (India)
  • 3 Apollo Gleneagles Hospitals, Kolkata 58, Canal Circular Road, Kolkata, West Bengal, 700054, India , Kolkata (India)
  • 4 Vasavi Medical & Research Centre, 2nd floor, No.6-1-91, Opposite Meera talkies, Khairatabad, Hyderabad, Telangana, 500004, India , Hyderabad (India)
  • 5 Nirmal Hospital, Gate no-3, Jhansi, Uttar Pradesh, 284128, India , Jhansi (India)
  • 6 Sassoon General Hospital, Pune, Maharashtra, 411011, India , Pune (India)
  • 7 GSVM Medical College, Swaroopa Nagar, Kanpur, U.P, 208002, India , Kanpur (India)
  • 8 King George Hospital, Visakhapatnam, Andhra Pradesh, 530002, India , Visakhapatnam (India)
  • 9 St.Theresa’s Hospital Erragadda, Sanathnagar, Hyderabad, Andhra Pradesh, 500018, India , Hyderabad (India)
  • 10 M.Jeevan Jyoti Multispecialty hospital & Infertility Research Centre, 162 Bai Ka Bagh, Lowther Road, Allahabad, Uttar Pradesh, 211003, India , Allahabad (India)
  • 11 Gurushree Hi-Tech Multi speicality Hopsital No.1558 Opp. Chandra layout Bus Stand Chandra Layout Vijaynagar, Bangalore, Karnataka, 560040, India , Bangalore (India)
  • 12 Rajiv Gandhi Insititute of Medical Sciences & RIMS Government General Hospital, Srikakulam, 532001, India , Srikakulam (India)
  • 13 Post graduate institute of medical education & Research, Sect, Chandigarh, or-12, India , Chandigarh (India)
  • 14 Civil Hospital, Asarva, Ahmedabad, Gujarat, 380016, India , Ahmedabad (India)
  • 15 Sapthagiri Institute of Medical Sciences and Research Center #15, Chikkasandra, Hesaraghatta Main Road, Bangalore, Karnataka, 560090, India , Bangalore (India)
Published Article
BMC Rheumatology
BioMed Central
Publication Date
Jun 04, 2020
DOI: 10.1186/s41927-020-00124-9
Springer Nature


BackgroundOur study aimed to compare efficacy and safety of Hetero’s adalimumab (Mabura®, Hetero Biopharma Limited) versus reference adalimumab (Humira®, Abbvie Inc.) in Indian patients with active rheumatoid arthritis (RA) concomitant on methotrexate (MTX) therapy.MethodsPatients (n = 168) were randomized (2:1) to receive either test or reference product for 24 weeks with concomitant MTX. Proportion of patients achieving American College of Rheumatology 20 (ACR20) criteria at week 12 was the primary endpoint. Changes in Disease Activity Score of 28 joints–C-reactive protein (DAS28-CRP), Health Assessment Questionnaire–Disability Index (HAQ-DI), and patients achieving ACR20 at week 24, ACR50/70 at weeks 12 and 24 were secondary endpoints.ResultsPatients achieving ACR20 responses with test (96.43%) were similar to reference (96.43%) in intention-to-treat (ITT) analysis at week 12. Proportional difference (PD) between groups (PD [95% CI] 0.0 [− 6.0, 6.0], p = 1.000) for ACR20 at week 12 for ITT analysis showed lower limit of the two-sided 95% CI was above the pre-specified noninferiority margin of − 15%. Similar trend in PP analysis (PD [95% CI] 0.0 [− 0.03, 0.07], p = 1.000), confirmed therapeutic equivalence. No significant difference was noted between arms for patients attaining ACR20 at week 24 and ACR50/70 at weeks 12 and 24 (all p > 0.05). DAS28-CRP and HAQ-DI were similar between groups. Total of 54 patients reported 88 AEs during the study. Out of these, 60 AEs were reported in 34 patients with Hetero-Adalimumab and 28 AEs were reported in 20 patients with Reference-Adalimumab. Total two patients, one in each group reported two serious adverse events (Sinusitis and Viral infection) during the study and resolved completely. No deaths and no life threatening AEs were reported.ConclusionResults demonstrated Hetero’s adalimumab is as effective and well tolerated as reference adalimumab in patients with active RA concomitantly on MTX therapy.Trial registrationCTRI/2016/04/006884, Registered on 28/04/2016.

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