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Biosimilar epoetin for cancer and chemotherapy-induced anaemia in the US 生成素生物仿制药在美国用于治疗癌症和化疗引起的贫血
Q2 Medicine Pub Date : 2021-09-15 DOI: 10.5639/gabij.2021.1003.015
Charles L. Bennett
Biosimilars are biological drug products that are highly similar to reference products in analytic features, pharmacokinetics and pharmacodynamics, immunogenicity, safety and efficacy. Biosimilar epoetin received US Food and Drug Administration (FDA) approval in 2018 [1]. The manufacturer received an FDA non-approval letter in 2017, despite receiving a favourable review by the FDA’s Oncologic Drugs Advisory Committee (ODAC) and an FDA non-approval letter in 2015 for an earlier formulation.
生物仿制药是指在分析特征、药代动力学和药效学、免疫原性、安全性和有效性方面与参比产品高度相似的生物药品。生物仿制药epoetin于2018年获得美国食品和药物管理局(FDA)批准[1]。尽管获得了FDA肿瘤药物咨询委员会(ODAC)的有利审查和2015年FDA对早期配方的非批准函,但该制造商在2017年收到了FDA的非批准函。
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引用次数: 0
A critical review of substitution policy for biosimilars in Canada 加拿大生物仿制药替代政策综述
Q2 Medicine Pub Date : 2021-09-15 DOI: 10.5639/gabij.2021.1003.016
Philip Schneider, M. Reilly
Abstract: Canada has approved a total of 36 biosimilars. While the approval of biosimilars is regulated at the national level, decisions about biosimilar substitution are made at the provincial level. Four Canadian provinces, representing around 50% of the population in Canada, have now implemented policies requiring non-medical switching of biosimilars – switching from a patient from an originator biological to a biosimilar primarily for economic reasons. In this article, we compare biosimilar substitution policies in Canada to policies in Europe and the US, finding an enhanced focus on clinical and marketplace factors in these regions. We also find evidence that in some cases non-medical switching may pose a risk to patients and suggest that Canada could learn from more mature markets, such as those in Europe, where switching policies better consider patient needs, preserve physician choice and promote market competition.
摘要:加拿大共批准了36个生物仿制药。虽然生物仿制药的批准是在国家层面进行监管的,但关于生物仿制药替代的决定是在省级层面做出的。加拿大四个省(约占加拿大人口的50%)现已实施了要求生物仿制药非医疗转换的政策,即主要出于经济原因将患者从原始生物仿制药转换为生物仿制药。在本文中,我们将加拿大的生物仿制药替代政策与欧洲和美国的政策进行了比较,发现这些地区更加关注临床和市场因素。我们还发现有证据表明,在某些情况下,非医疗转换可能对患者构成风险,并建议加拿大可以向更成熟的市场学习,例如欧洲的市场,在这些市场,转换政策更好地考虑了患者的需求,保留了医生的选择并促进了市场竞争。
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引用次数: 0
An overview of the current status of follow-on biologicals in Iran 伊朗后续生物制剂的现状概述
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.010
Farhang Rezaei, N. Anjidani
Background The advent of follow-on biologicals in Iran and biosimilars worldwide have provided various treatment options for several severe and chronic diseases. The goal of the present study was to provide an overview of their current status in Iran. Methods A comprehensive search of clinical trial registry sites and other databases that publish scholarly articles, such as PubMed and Google scholar, enabled the current follow-on biologicals landscape in Iran to be mapped. In addition, the annual national wholesale data of pharmaceutical products published by the Iranian pharmaceutical regulatory were analysed. The share of biotechnological therapeutics in terms of the whole medicines market, was evaluated, along with the share of follow-on biologicals and the potential and actualized cost-saving associated with using them. Data were collected and analysed over the 2013–2018 time period. Results At the time of writing, 21 follow-on biologicals were available in Iran and these are related to 17 different originator molecules. In 2018, approximately 13.5% of medicines spending in Iran was devoted to biotechnological therapeutics. Follow-on biologicals comprised approximately 47.2% of the biotechnological therapeutics’ total market value, up from 35.2% in 2013. The use of follow-on biologicals in Iran was associated with more than US$300 million cost-saving in 2018. A number of follow-on biological candidates, mostly monoclonal antibodies, are under development and will be subject to head-to-head clinical trials against originator products prior to regulatory approval and marketing. Conclusion Despite a significant rise in the use of follow-on biologicals in Iran, the proportional use of biotechnological therapeutics compared to the total medicines market has remained constant in recent years. Iranian healthcare authorities can improve patients’ access to life-saving biological medicines through promoting the use of follow-on biologicals instead of costly originators after making sure of the quality, efficacy and safety of the follow-on biologicals. The significant cost saving associated with using follow-on biologicals can also be utilized for other biotechnological medicines that are not currently in Iran’s drug list.
伊朗后续生物制剂和世界范围内生物仿制药的出现为几种严重和慢性疾病提供了各种治疗选择。本研究的目的是概述他们在伊朗的现状。方法对临床试验注册站点和其他发表学术文章的数据库(如PubMed和Google scholar)进行全面搜索,绘制出伊朗目前的后续生物制剂图景。此外,还分析了伊朗药品监管机构公布的年度全国药品批发数据。评估了生物技术疗法在整个药品市场中的份额,以及后续生物制剂的份额,以及与使用它们相关的潜在和实际成本节约。收集和分析了2013-2018年期间的数据。结果在撰写本文时,伊朗有21种后续生物制剂,这些生物制剂与17种不同的起源分子有关。2018年,伊朗约13.5%的药品支出用于生物技术治疗。后续生物制剂约占生物技术治疗总市值的47.2%,高于2013年的35.2%。2018年,伊朗使用后续生物制剂节省了3亿多美元的成本。一些后续生物候选药物,主要是单克隆抗体,正在开发中,在监管部门批准和上市之前,将与原研产品进行正面临床试验。尽管伊朗后续生物制剂的使用显著增加,但近年来生物技术疗法的使用与总药品市场的比例保持不变。伊朗卫生保健当局可以在确保后续生物制剂的质量、功效和安全性之后,通过促进使用后续生物制剂而不是昂贵的原药,改善患者获得救生生物药品的机会。与使用后续生物制品相关的大量成本节约也可用于目前不在伊朗药物清单上的其他生物技术药物。
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引用次数: 0
Biosimilars in Saudi Arabia: a single-centre, open-label case series examining infliximab switching 沙特阿拉伯的生物仿制药:单中心,开放标签病例系列检查英夫利昔单抗切换
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.007
Mansour Somaily, Hana S Alahmari, W. Abbag, Shahenda Yousif, Nawar Tayfour, N. Almushayt, Saleh Alhusayni, Saeed Almajadiah
Background: A biosimilar version of infliximab ( CT-P13) was recently approved for use in Saudi Arabia. Clinical data support its use in the treatment of rheumatic disease, however, there is a lack of local data regarding the efficacy and tolerability of CT-P13 among patients with rheumatological disorders in Saudi Arabia. Objectives: To investigate the feasibility, tolerability and immunogenicity of switching from originator infliximab to biosimilar infliximab, CT-P13, in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and Behçet’s disease (BD). Methodology: The study included patients who were being treated with originator infliximab in the Department of Rheumatology in Khamis Mushayt General Hospital, Saudi Arabia, and were required to switch to biosimilar infliximab (CT-P13) between January 2018 and June 2019. Patient follow-up was carried out every three months for one year. The disease activity score 28 (DAS28) was used to assess RA severity. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was used to measure disease activity in patients with AS, while BD disease activity was based on clinical assessment. Results: In total, 13 patients (six with RA, five with AS and two with BD) were switched to biosimilar infliximab. The majority (n = 11/13) remained on biosimilar infliximab throughout the follow-up period with no reported major adverse events. Overall, there was a significant improvement in RA disease activity following biosimilar treatment, with the mean DAS28 decreasing from 3.61±1.24 before biosimilar therapy to 2.63±1.54 one year after switching. Conclusion: In patients with AS, BD, or RA who switched from originator infliximab to the biosimilar, CT-P13, we did not observe any significant differences in tolerability or efficacy between biosimilar and originator. Furthermore, disease activity significantly declined in RA patients following biosimilar treatment
背景:英夫利昔单抗(CT-P13)的生物仿制药版本最近被批准在沙特阿拉伯使用。临床数据支持其在风湿病治疗中的应用,然而,沙特阿拉伯缺乏关于CT-P13在风湿病患者中的疗效和耐受性的本地数据。目的:探讨类风湿性关节炎(RA)、强直性脊柱炎(AS)和behet病(BD)患者从原药英夫利昔单抗转向生物仿制药英夫利昔单抗CT-P13的可行性、耐受性和免疫原性。方法:该研究纳入了在沙特阿拉伯Khamis Mushayt总医院风湿病科接受原药英夫利昔单抗治疗的患者,这些患者被要求在2018年1月至2019年6月期间改用生物仿制药英夫利昔单抗(CT-P13)。患者每3个月随访1年。疾病活动评分28 (DAS28)用于评估RA的严重程度。巴斯强直性脊柱炎疾病活动性指数(BASDAI)评分用于衡量AS患者的疾病活动性,而BD疾病活动性基于临床评估。结果:共有13例患者(6例RA, 5例AS, 2例BD)改用英夫利昔单抗生物仿制药。大多数(n = 11/13)在整个随访期间仍在使用英夫利昔单抗生物仿制药,没有报告重大不良事件。总体而言,生物仿制药治疗后RA疾病活动性显著改善,平均DAS28从生物仿制药治疗前的3.61±1.24降至切换后一年的2.63±1.54。结论:在从原药英夫利昔单抗切换到生物仿制药CT-P13的AS, BD或RA患者中,我们没有观察到生物仿制药和原药之间的耐受性或疗效有任何显着差异。此外,RA患者在接受生物类似药治疗后,疾病活动性显著下降
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引用次数: 1
The EU regulatory network and emerging trends – a review of quality, safety and clinical development programmes 欧盟监管网络和新兴趋势——对质量、安全性和临床开发项目的回顾
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.009
Marta Zuccarelli, Benjamin Micallef, Mark Cilia, A. Serracino-Inglott, J. Borg
Introduction/Study Objectives: The development of biosimilars is challenging due to the complexity of the active substances as well as the strict regulatory requirements to show similarity with a reference medicinal product. This review aims to describe the regulatory experience of approving biosimilars in the European Union (EU) within the EU framework, identify emerging trends in the EU regulatory pathway when approving biosimilars and discuss where the EU biosimilar framework is heading. Methods: Marketing authorisation applications (MAAs) submitted up to 2019 were retrieved from the public domain. The European public assessment report database was searched for approved biosimilars and clinical development programmes of biosimilars belonging to the same class were reviewed. In order to observe if biosimilars released onto the market increased safety concerns, we compared disproportionate adverse event reports pre- and post-licensure. Results: Up to December 2019, 90 MAAs were submitted and 53 biosimilars were approved for 14 different biologicals. Total number of clinical trials (both phase I and III) steadily goes up driven by an increase number of approvals in later years, while the average number of both phase I and III trials decreased over time with some with Pegfilgrastim biosimilars being approved without conducting any phase III clinical trials. No new safety concerns were identified from the analysis of disproportionate adverse event reports. Discussion: Clinical development programmes of biosimilars and the requirements set for biosimilars approval are changing over time. Biosimilars approved seem to be as well tolerated as the reference products when approved based on stringent regulatory requirements. Conclusion: Regulation of biosimilars is progressing as more knowledge is gained.
介绍/研究目的:由于活性物质的复杂性以及与参比药物相似的严格监管要求,生物类似药的开发具有挑战性。本综述旨在描述欧盟框架内批准生物仿制药的监管经验,确定批准生物仿制药时欧盟监管途径中的新趋势,并讨论欧盟生物仿制药框架的发展方向。方法:从公共领域检索截至2019年提交的上市许可申请(MAAs)。检索欧洲公共评估报告数据库,查找已批准的生物仿制药,并审查属于同类生物仿制药的临床开发计划。为了观察投放市场的生物仿制药是否增加了安全性问题,我们比较了许可前后不成比例的不良事件报告。结果:截至2019年12月,14种不同生物制剂共提交了90个maa, 53个生物仿制药获批。临床试验总数(包括I期和III期)在后期批准数量的增加的推动下稳步上升,而I期和III期试验的平均数量随着时间的推移而减少,一些Pegfilgrastim生物类似药在没有进行任何III期临床试验的情况下被批准。从不成比例的不良事件报告分析中没有发现新的安全问题。讨论:生物仿制药的临床开发计划和生物仿制药批准的要求正在随着时间的推移而变化。经批准的生物仿制药在严格的监管要求下获得批准时,似乎与参考产品一样具有良好的耐受性。结论:生物仿制药的监管随着知识的积累而不断进步。
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引用次数: 0
Summative usability evaluation of the YLB113 etanercept biosimilar autoinjector via simulation 通过仿真对YLB113依那西普生物仿制药自动注射器的可用性进行总结性评价
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.006
K. Canham, C. Newcomb
Introduction/Study Objectives: Etanercept is a tumour necrosis factor inhibitor indicated for the treatment of several inflammatory disorders. Patients with these diseases may experience manual dexterity challenges. Autoinjectors may improve dose accuracy, treatment adherence and quality of life; and reduce injection-site reactions. Studies have indicated patients prefer autoinjectors to other injection methods, however, patients must be able to demonstrate safe and effective use of an autoinjector for it to be a viable option. The YLB113 etanercept autoinjector may be a substitutable biosimilar to reference etanercept (Pfizer Manufacturing, Puurs, Belgium). This study sought to confirm intended users of the YLB113 etanercept autoinjector could demonstrate safe and effective use. Methods: The evaluation was performed among 79 participants representative of intended YLB113 etanercept autoinjector users; and included patients, caregivers and healthcare providers (HCPs). Results: All participants successfully delivered two simulated doses of etanercept into the foam pad using the autoinjector. Some participants experienced user errors, use difficulties, or close calls while simulating injection or answering knowledge questions. Discussion: In this usability evaluation, study patients, caregivers and HCPs demonstrated a high rate of injection success using the YLB113 etanercept autoinjector. Conclusions: The study results support demonstration of safe and effective use of the YLB113 etanercept autoinjector, a substitutable biosimilar to reference etanercept.
简介/研究目的:依那西普是一种肿瘤坏死因子抑制剂,可用于治疗多种炎症性疾病。患有这些疾病的患者可能会遇到手灵巧性的挑战。自体注射器可以提高剂量准确性、治疗依从性和生活质量;减少注射部位的反应。研究表明,与其他注射方法相比,患者更喜欢使用自动注射器,然而,患者必须能够证明安全有效地使用自动注射器才能成为一种可行的选择。YLB113依那西普自动注射器可能是参考依那西普的可替代生物仿制药(辉瑞制造公司,比利时Puurs)。本研究旨在确认YLB113依那西普自动注射器的预期用户可以证明安全有效的使用。方法:在79名代表YLB113依那西普自动注射器使用者的参与者中进行评估;包括患者、护理人员和医疗保健提供者(HCPs)。结果:所有参与者都成功地使用自动注射器将两种模拟剂量的依那西普送入泡沫垫。一些参与者在模拟注射或回答知识问题时经历了用户错误、使用困难或死里逃生。讨论:在这项可用性评估中,研究患者、护理人员和医护人员证明使用YLB113依那西普自动注射器的注射成功率很高。结论:研究结果支持YLB113依那西普自动注射器的安全有效使用,这是一种可替代参考依那西普的生物类似物。
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引用次数: 0
Repurposing non-oncology drugs for cancer treatment 将非肿瘤药物重新用于癌症治疗
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.011
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引用次数: 0
What to look forward to in GaBI Journal, 2021, Issue 2 《GaBI杂志》2021年第2期有什么值得期待的
Q2 Medicine Pub Date : 2021-06-15 DOI: 10.5639/gabij.2021.1002.005
P. Walson
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引用次数: 0
First 2021 GaBI Journal issue highlights 2021年第一期GaBI期刊亮点
Q2 Medicine Pub Date : 2021-03-15 DOI: 10.5639/GABIJ.2021.1001.001
P. Walson
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引用次数: 0
Biosimilars – status in July 2020 in 16 countries 生物仿制药- 2020年7月在16个国家获得批准
Q2 Medicine Pub Date : 2021-03-15 DOI: 10.5639/gabij.2021.1001.002
Hye-Na Kang, R. Thorpe, I. Knezevic, Daehyun Baek, Parichard Chirachanakul, H. M. Chua, D. Dalili, F. Foo, K. Gao, Suna Habahbeh, Hugo Hamel, E. Nkansah, M. Savkina, O. Semeniuk, Shraddha Srivastava, João Tavares Neto, M. Wadhwa, Teruhide Yamaguchi
The World Health Organization has provided specific guidance for biosimilar products to assist regulators, manufacturers and other professionals involved in the development and evaluation of these products. The development and approval of biosimilars are important for health care, as they allow the marketing of safe, efficacious and affordable biological products. Since the first biosimilars were approved in the EU in 2006, a series of biosimilars have been approved in many countries/geographical regions. This manuscript provides the figures on the status of approved biosimilars in 16 countries based on the information from regulatory experts and from publicly available data. It is clear that increasing numbers of biosimilars are now available in many countries and provide more options for treatments. It is expected that adoption of biosimilars will allow affordable health care and greater patient access to important medicinal products. It will also contribute to the overall WHO goal recognized by the World Health Assembly in 2014 by adopting a resolution on access to biotherapeutic products including biosimilars and on ensuring their quality, safety and efficacy.
世界卫生组织为生物类似药产品提供了具体指导,以协助监管机构、制造商和参与开发和评价这些产品的其他专业人员。生物仿制药的开发和批准对卫生保健很重要,因为它们允许销售安全、有效和负担得起的生物产品。自2006年第一批生物仿制药在欧盟获得批准以来,一系列生物仿制药已在许多国家/地区获得批准。本文根据监管专家的信息和公开数据,提供了16个国家批准的生物仿制药状况的数据。很明显,现在许多国家有越来越多的生物仿制药可供使用,并为治疗提供了更多的选择。预计采用生物仿制药将使人们能够负担得起医疗保健费用,并使更多的患者能够获得重要的医药产品。它还将通过一项关于获取包括生物仿制药在内的生物治疗产品以及确保其质量、安全性和有效性的决议,从而促进2014年世界卫生大会确认的世卫组织总体目标。
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引用次数: 3
期刊
GaBI Journal-Generics and Biosimilars Initiative Journal
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