According to clinical studies, what is the typical impact of multiple switches between reference biologics and biosimilars? efficacy tends to increase after each switch efficacy tends to decrease afte

According to clinical study evidence, the typical impact of multiple switches between a reference biologic and a biosimilar is that efficacy is generally maintained (i.e., there’s no consistent decline or improvement pattern).

So the correct choice from your options is: “efficacy tends to remain stable” / “no clinically meaningful change in efficacy after multiple switches.”

(Importantly, studies looking at interchangeability/switching—such as for agents like infliximab, adalimumab, and others—usually show similar efficacy and safety, with variations typically within the normal range of clinical trial variability, rather than a systematic increase or decrease.)