Formulary And Therapeutic Alternatives Practice Test

A 54-year-old female (77 kg) with ulcerative colitis receives infliximab 5 mg/kg intravenously every 8 weeks; the infusion center is switching to a formulary-preferred biosimilar. Current medications: infliximab, mesalamine 2.4 g daily; allergies: none. Labs: SCr 0.8 mg/dL, AST/ALT within normal limits; history: infusion reaction (mild flushing) controlled with slower rate. Which biosimilar is equivalent for this patient?

A 45-year-old woman (weight 74 kg) with rheumatoid arthritis is stable on adalimumab 40 mg subcutaneously every other week. Her insurance now requires use of an FDA-approved adalimumab biosimilar on formulary; the plan covers adalimumab-adbm and adalimumab-afzb. Current medications: adalimumab 40 mg subcutaneously every other week, methotrexate 15 mg by mouth once weekly, folic acid 1 mg by mouth once daily; allergy: sulfonamides (rash). Labs: aspartate aminotransferase 22 U/L (10–40), alanine aminotransferase 25 U/L (7–56), serum creatinine 0.8 mg/dL (0.6–1.3). Which biosimilar is equivalent for this patient?