The FDA has approved Celltrion's Avtozma (tocilizumab-anoh) as a biosimilar to Actemra (tocilizumab), offering a new treatment option for multiple inflammatory conditions. This approval, announced on January 31, 2025, includes both intravenous (IV) and subcutaneous (SC) formulations, providing physicians and patients with increased flexibility in managing diseases such as rheumatoid arthritis (RA), giant cell arteritis (GCA), polyarticular juvenile idiopathic arthritis (pJIA), systemic juvenile idiopathic arthritis (sJIA), and COVID-19. The decision is based on comprehensive clinical data demonstrating Avtozma's biosimilarity to Actemra, potentially increasing accessibility and reducing costs for healthcare systems and patients.
Clinical Trial Data Supporting Approval
The FDA's approval was supported by data from a Phase 3 clinical trial, which demonstrated biosimilarity between Avtozma and reference tocilizumab in patients with moderate to severe active RA. The study met its primary endpoint, showing comparable improvement from baseline in Disease Activity Score using 28 joints (DAS28) with erythrocyte sedimentation rate (ESR) at Week 24. One-year results further supported the comparability of Avtozma and reference tocilizumab in terms of secondary efficacy, pharmacokinetics, safety, and immunogenicity. According to Celltrion, these clinical results validate that Avtozma and its reference tocilizumab are highly similar and have no clinically meaningful differences regarding efficacy, safety, pharmacokinetics (PK) and immunogenicity.
Tom Nusbickel, chief commercial officer at Celltrion USA, noted that the availability of both IV and SC formulations provides flexibility and a wider range of treatment options, allowing tailored treatment based on individual needs and preferences. He added, "This approval represents a strategic addition to Celltrion’s immunology portfolio, further strengthening our commitment to delivering accessible and high-quality treatment options for patients and health care providers."
Dosage and Administration
Avtozma will be available in both IV and SC formulations, mirroring the dosages of the reference product. The IV infusion is provided in strengths of 80 mg/4 mL, 200 mg/10 mL, and 400 mg/20 mL, while the SC injection is available as 162 mg/0.9 mL in a single-dose prefilled syringe or autoinjector.
Impact on the Treatment Landscape
The introduction of Avtozma as a biosimilar to Actemra is expected to increase competition in the market, potentially leading to greater accessibility and cost savings for healthcare systems and patients. Actemra, a recombinant humanized monoclonal antibody and IL-6 receptor antagonist, has been a key treatment for inflammatory conditions. Avtozma's approval marks Celltrion's seventh biosimilar to receive marketing authorization in the U.S., further solidifying its presence in the immunology space. With the increasing number of approved tocilizumab biosimilars, healthcare systems can anticipate enhanced savings and sustainability, along with improved physician and patient access to biologics.
Safety Considerations
Avtozma carries a warning regarding the risk of serious infections, similar to Actemra. Patients should be monitored for signs of infection, including tuberculosis, during and after treatment. The prescribing information includes contraindications for patients with known hypersensitivity to tocilizumab products. Common adverse reactions include upper respiratory tract infections, nasopharyngitis, headache, hypertension, and elevated alanine aminotransferase (ALT) levels.
