©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Mar 7, 2026; 32(9): 114580
Published online Mar 7, 2026. doi: 10.3748/wjg.v32.i9.114580
Published online Mar 7, 2026. doi: 10.3748/wjg.v32.i9.114580
Comparable remission and health care use in real-world inflammatory bowel disease patients initiating originator biologics vs biosimilars
Cristiano S Moura, Luck Lukusa, Sasha Bernatsky, Centre for Outcomes Research and Eva
Albert Etingin, Core Internal Medicine Residency Program, Department of Medicine, McGill University, Montreal H4A 3J1, Quebec, Canada
Harminder Singh, Department of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 3P5, Manitoba, Canada
Neeraj Narula, Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton L8N 3ZN, Ontario, Canada
Laura E Targownik, Department of Medicine, University of Toronto, Toronto M5S 1A1, Onta
Laura E Targownik, Division of Gastroenterology and Hepatology, Mount Sinai Hospital, Toronto M5G 1X5, Ontario, Canada
Yvette Leung, Department of Medicine, University of British Columbia, Vancouver V6T 1Z4, British Columbia, Canada
Petros Zezos, Beata Polewiczowska-Nowak, NOSM University, Thunder Bay Regional Health Sciences Centre, Thunder Bay P7B 7A5, Ontario, Canada
Waqqas Afif, Sasha Bernatsky, Department of Medicine, McGill University, Montreal H4A 3J1, Quebec, Canada
Author contributions: Moura CS, Lukusa L, Singh H, Narula N, Targownik LE, Leung Y, Zezos P, Afif W, Bernatsky S contributed to the conception and design, and execution of the study; and all authors contributed to acquisition of data, analysis and interpretation of data; Moura CS, Etingin A, and Lukusa L drafted the article; and all authors revised the manuscript critically for important intellectual content and provided final approval of the version to be submitted.
Supported by the Canadian Institutes for Health Research, No. DES-156672.
Institutional review board statement: The study protocol was approved by the McGill University Health Centre REB (No. MP-37-2019-4560), Hamilton Integrated REB (No. 5886), Mount Sinai Hospital REB (No. 18-0327-E), Thunder Bay Regional Health Sciences Centre REB (No. 100172), University of Manitoba Health REB (No. HS22494), and UBC-Providence Health Care Research Institute (No. H18-02301-A011).
Informed consent statement: All study participants, or their legal guardian, provided informed written informed consent prior to study enrollment.
Conflict-of-interest statement: Singh H has been on advisory boards or consulted for Fresenius Kabi Canada, AbbVie Canada, Amgen Canada, Pfizer Canada, Takeda Canada, Innomar Strategies, Organon Canada, Pendopharm, Eli Lilly Canada and Guardant Health Inc., received educational funding from Pfizer Canada, Fresenius Kabi Canada, Organon Canada and has received research funding for an investigator-initiated study from Pfizer and research in kind support from Pendopharm. Singh H holds shares from VasCon; NN holds a McMaster University AFP Clinician Researcher Award. Narula N has received honoraria and/or grant support from Janssen Johnson & Johnson, Abbvie, Takeda, Pfizer, Celltrion, Amgen, Organon, and Ferrin; Targownik LE has personal fees and non-financial support (advisory boards, speaker panels, writing support, trial design, staff training) from AbbVie Canada, Johnson & Johnson Innovative Medicine, Takeda Canada, Amgen Canada, Merck Canada, Organon Canada, Pfizer Canada, Lilly Canada, Bristol Myers Squibb Canada outside of this work. Leung Y has received personal fees (talk and advisory board) from Celltrion, Janssen, Abbvie, Eli Lilly, Takeda, and Pfizer. Leung Y received non-financial support from Takeda and Pfizer for studies. Afif W has received honoraria and grant support from AbbVie, Amgen, Avir Pharma, Celltrion, Eli-Lilly, Eupraxia, Ferring, GSK, Janssen, JAMP Pharma, Merck, Pendopharm, Pfizer, Roche, Sandoz, Sanofi and Takeda. Moura CS, Etingin A, Lukusa L, Zezos P, Polewiczowska-Nowak B, Bernatsky S have nothing to declare.
STROBE statement: The authors have read the STROBE Statement—checklist of items—and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. De-identified, anonymized data may be shared upon reasonable request to the corresponding author.
Corresponding author: Sasha Bernatsky, MD, PhD, Professor, Centre for Outcomes Research and Evaluation, The Research Institute of the McGill University Health Centre, 5252 Boul de Maisonneuve Ouest, Montreal H4A 3S5, Quebec, Canada. sasha.bernatsky@mcgill.ca
Received: September 28, 2025
Revised: November 10, 2025
Accepted: January 19, 2026
Published online: March 7, 2026
Processing time: 153 Days and 17.2 Hours
Revised: November 10, 2025
Accepted: January 19, 2026
Published online: March 7, 2026
Processing time: 153 Days and 17.2 Hours
Core Tip
Core Tip: Biologic therapies are effective for many people with inflammatory bowel disease, but they are expensive. Biosimilars are equivalent, lower-cost versions of biologic originators, yet real-world evidence comparing their effectiveness remains limited. We analyzed data from a Canadian multicenter registry including adults living with Crohn’s disease or ulcerative colitis, initiating originator or biosimilar. Outcomes of interest were remission and health care resource use. We found no clear differences in remission, hospitalizations, or emergency visits between the two groups. These findings support broader adoption of biosimilars and provide reassurance to patients and clinicians regarding their comparable effectiveness.