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Real-World Effectiveness and Safety of SDZ-ADL (Adalimumab Biosimilar) in Patients with Psoriasis from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) 来自英国皮肤病学家协会生物和免疫调节剂注册中心(BADBIR)的SDZ-ADL(阿达木单抗生物类似物)在银屑病患者中的真实有效性和安全性
Pub Date : 2022-09-30 DOI: 10.3390/biologics2040017
L. Puig, K. Shams, F. Furlan, Cristofer Salvati, Elisa Romero, J. Fan, L. Iversen
SDZ-ADL is a biosimilar of reference adalimumab. Here, the safety and effectiveness data of SDZ-ADL from the British Association of Dermatologists Biologic and Immuno-modulators Register (BADBIR) are reported. In the safety set, data of SDZ-ADL were compared with conventional systemics data. In the effectiveness set, the effectiveness and quality-of-life of patients treated with SDZ-ADL as a first-time biologic, or who switched from a previous biologic to SDZ-ADL, were assessed using the Psoriasis Activity Severity Index (PASI) and Dermatology Life Quality Index (DLQI), respectively. A total of 565 (incidence rate (IR) per 1000 person-years 29.1, 95% CI 26.8–31.6) serious infections and 48 (IR 2.5, 95% CI 1.8–3.3) myocardial infarction events were reported in the conventional systemics cohort compared with four (IR 31.5, 95% CI 8.6–80.7) and one (IR 7.9, 95% CI 0.2–43.9) in the biologic cohort, respectively. One patient (0.7% (1/136)) reported injection-site pain in the biologic cohort. At 12 months, PASI ≤ 2 was achieved in 84.6% (11/13) and 76.9% (10/13) and DLQI 0/1 was achieved in 70% (7/10) and 75% (3/4) of patients in the biologic-naïve and biologic-switch cohorts, respectively. After one year of therapy, 82.7% (110/133) patients remained on SDZ-ADL. SDZ-ADL was well-tolerated and effective in patients with psoriasis.
SDZ-ADL是参比阿达木单抗的生物类似物。本文报道了来自英国皮肤病学家协会生物和免疫调节剂注册中心(BADBIR)的SDZ-ADL的安全性和有效性数据。在安全集合中,将SDZ-ADL的数据与传统的系统学数据进行比较。在有效性集中,分别使用银屑病活动严重程度指数(PASI)和皮肤病学生活质量指数(DLQI)评估首次使用SDZ-ADL生物治疗的患者或从以前的生物治疗转为SDZ-ADL的患者的有效性和生活质量。常规系统学队列中共报告565例(发病率(IR)/1000人-年29.1,95%CI 26.8–31.6)严重感染和48例(IR 2.5,95%CI 1.8–3.3)心肌梗死事件,而生物队列中分别报告了4例(IR 31.5,95%CI 8.6–80.7)和1例(IR 7.9,95%CI 0.2–43.9)。生物学队列中有一名患者(0.7%(1/136))报告注射部位疼痛。在12个月时,在生物幼稚和生物转换队列中,分别有84.6%(11/13)和76.9%(10/13)的患者实现了PASI≤2,70%(7/10)和75%(3/4)的患者达到了DLQI 0/1。治疗一年后,82.7%(110/133)的患者仍在SDZ-ADL中。SDZ-ADL对银屑病患者具有良好的耐受性和有效性。
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引用次数: 0
Changes in SpO2 on Room Air for 34 Severe COVID-19 Patients after Ivermectin-Based Combination Treatment: 62% Normalization within 24 Hours 34例重症COVID-19患者伊维菌素联合治疗后室内空气SpO2变化:24小时内恢复62%
Pub Date : 2022-08-31 DOI: 10.3390/biologics2030015
Jaqueline C. Stone, Pisirai Ndarukwa, D. Scheim, B. Dancis, J. Dancis, Martin G. Gill, Colleen Aldous
The emergence of COVID-19 in March 2020 challenged Zimbabwe to respond with limited medical facilities and therapeutic options. Based on early clinical indications of efficacy for the macrocyclic lactone, Ivermectin (IVM), against COVID-19, IVM-based combination treatments were deployed to treat it. Oxygen saturation (SpO2) data were retrospectively analyzed for 34 severe, hypoxic COVID-19 patients all on room air (without supplemental oxygen). The patients, median age 56.5, were treated at clinics or at home between August 2020 and May 2021. All but three of these 34 patients had significantly increased SpO2 values within 24 h after the first IVM dose. The mean increase in SpO2 as a percentage of full normalization to SpO2 = 97 was 55.1% at +12 h and 62.3% at +24 h after the first IVM dose (paired t-test, p < 0.0000001). These results parallel similar sharp, rapid increases in SpO2, all on room air, for 24 mostly severe COVID-19 patients in the USA (California) who were given an IVM-based combination treatment. All patients in both of these critical series recovered. These rapid increases in SpO2 values after IVM treatment stand in sharp contrast to declines in SpO2 and associated pulmonary function through the second week following the onset of moderate or severe COVID-19 symptoms under standard care.
2019冠状病毒病于2020年3月出现,津巴布韦面临着以有限的医疗设施和治疗方案应对疫情的挑战。根据大环内酯伊维菌素(IVM)抗COVID-19的早期临床适应症,采用基于IVM的联合治疗方案进行治疗。回顾性分析34例重度低氧COVID-19患者的血氧饱和度(SpO2)数据,所有患者均使用室内空气(无补充氧气)。这些患者的中位年龄为56.5岁,在2020年8月至2021年5月期间在诊所或家中接受治疗。34例患者中除3例外,均在首次IVM给药后24小时内SpO2值显著升高。第一次IVM给药后12小时,SpO2完全正常化至SpO2 = 97的平均百分比为55.1%,24小时时为62.3%(配对t检验,p < 0.0000001)。这些结果与美国(加利福尼亚州)24名接受ivm联合治疗的重症COVID-19患者的SpO2相似,均在室内空气中急剧快速增加。两组患者均康复。IVM治疗后SpO2值的快速增加与在标准治疗下出现中度或重度COVID-19症状后第二周内SpO2和相关肺功能的下降形成鲜明对比。
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引用次数: 6
Why Are We Still Talking about Ivermectin? Editorial Note on Stone et al. Changes in SpO2 on Room Air for 34 Severe COVID-19 Patients after Ivermectin-Based Combination Treatment 为什么我们还在谈论伊维菌素?Stone等人的编辑说明。34名重症新冠肺炎患者在伊维菌素联合治疗后房间空气中SpO2的变化
Pub Date : 2022-08-31 DOI: 10.3390/biologics2030016
S. Pincus
In this issue of Biologics, we publish an article describing a surprising clinical effect of the anti-helminthic drug ivermectin on patients with COVID-19 [...]
在本期《生物学》杂志上,我们发表了一篇文章,描述了抗蠕虫药物伊维菌素对新冠肺炎患者的惊人临床效果[…]
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引用次数: 0
Biosimilars: Harmonizing the Approval Guidelines 生物仿制药:统一审批指南
Pub Date : 2022-07-28 DOI: 10.3390/biologics2030014
Sarfaraz K Niazi
Biosimilar approval guidelines need rationalization and harmonization to remove the inconsistencies and misconceptions to enable faster, safer, and more cost-effective biosimilars. This paper proposes a platform for a model guideline based on the scientific evaluation of the regulatory filings of the 130+ products approved in the US, UK, and EU and hundreds more in the WHO member countries. Extensive literature survey of clinical data published and reported, including Clinicaltrials.gov, a review of all current guidelines in the US, UK and EU, and WHO, and detailed discussions with the FDA have confirmed that removing the animal and clinical efficacy testing and fixing other minor approaches will enable the creation of a harmonized guideline that will best suit an ICH designation.
生物仿制药审批指南需要合理化和协调,以消除不一致和误解,从而实现更快、更安全、更具成本效益的生物仿制药。本文基于对美国、英国和欧盟批准的130多种产品以及世卫组织成员国批准的数百种产品的监管文件的科学评估,提出了一个示范指南的平台。对已发表和报告的临床数据的广泛文献调查,包括Clinicaltrials.gov,对美国、英国和欧盟以及世卫组织所有现行指南的审查,以及与FDA的详细讨论,已经证实,取消动物和临床疗效测试并确定其他次要方法将能够创建最适合ICH指定的统一指南。
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引用次数: 7
Aged Population and Immunocompromised Patients: Impact on SARS-CoV-2 Variants and Treatment Outcomes 老年人群和免疫功能低下患者:对SARS-CoV-2变异和治疗结果的影响
Pub Date : 2022-07-22 DOI: 10.3390/biologics2030013
Vivek P. Chavda, M. Chhabria, V. Apostolopoulos
Patients with an immunocompromised state are at risk of developing a long-term infection from the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2) [...]
免疫功能低下的患者有可能长期感染导致严重急性呼吸综合征(严重急性呼吸系统综合征冠状病毒2型)的冠状病毒2型[…]
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引用次数: 1
Antimicrobial Resistance (AMR) in Italy over the Past Five Years: A Systematic Review 意大利过去五年的抗微生物耐药性(AMR):系统综述
Pub Date : 2022-06-13 DOI: 10.3390/biologics2020012
M. Montalti, G. Soldà, Angelo Capodici, Z. Di Valerio, G. Gribaudo, Giusy La Fauci, A. Salussolia, Francesca Scognamiglio, A. Zannoner, D. Gori
Antimicrobial Resistance (AMR) has become a global threat to public health systems around the world in recent decades. In 2017, Italy was placed among the worst-performing nations in Europe by the European Centre for Disease Prevention and Control, due to worryingly high levels of AMR in Italian hospitals and regions. The aim of this systematic review was to investigate the state of the art of research on AMR in Italy over the last five years. The PubMed database was searched to identify studies presenting original data. Forty-three of the 9721 records identified were included. Overall, AMR rates ranged from 3% (in a group of sheep farmers) to 78% (in a hospital setting). The methods used to identify the microorganisms, to test their susceptibility and the criteria adopted for the breakpoint were deficient in 7, 7 and 11 studies, respectively. The main findings of our review were that most studies (79.1%) considered hospitalised patients only, 4 studies (9.3%) analysed non-hospitalised populations only. In addition, only 7 studies were multicentric and no scientific literature on the subject was produced in 7 Italian regions. In order to have a solid basis on the topic for the interventions of public health professionals and other stakeholders, studies analysing the phenomenon should be conducted in a methodologically standardised manner, should include all areas of the country and should also focus on out-of-hospital and community-based care and work settings.
近几十年来,抗微生物耐药性(AMR)已成为全球公共卫生系统的威胁。2017年,由于意大利医院和地区的AMR水平高得令人担忧,意大利被欧洲疾病预防和控制中心列为欧洲表现最差的国家之一。本系统综述的目的是调查过去五年来意大利AMR的研究现状。检索PubMed数据库以确定提供原始数据的研究。在已确定的9721份记录中,有43份被包括在内。总体而言,AMR发病率从3%(在一群养羊人中)到78%(在医院环境中)不等。用于鉴定微生物、测试其易感性的方法和断点采用的标准分别在7项、7项和11项研究中存在缺陷。我们综述的主要发现是,大多数研究(79.1%)仅考虑住院患者,4项研究(9.3%)仅分析非住院人群。此外,只有7项研究是多中心的,意大利7个地区没有关于该主题的科学文献。为了为公共卫生专业人员和其他利益相关者的干预奠定坚实的基础,分析这一现象的研究应以方法标准化的方式进行,应包括全国所有地区,还应侧重于院外和社区护理和工作环境。
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引用次数: 3
Abelmoschus esculentus (L.) Moench Pod Extract Revealed Antagonistic Effect against the Synergistic Antidiabetic Activity of Metformin and Acarbose upon Concomitant Administration in Glucose-Induced Hyperglycemic Mice Abelmoschus esculentus(L.)Moench Pod提取物对葡萄糖诱导的高血糖小鼠同时给予二甲双胍和阿卡波糖的协同抗糖尿病活性显示拮抗作用
Pub Date : 2022-05-10 DOI: 10.3390/biologics2020010
Md Anamul Haque, Md. Sanower Hossain, Nur Muhammad Abu Sayed, Mohammad Touhidul Islam, Md. Robin Khan, F. Ahmmed, F. T. Zohora, D. Ağagündüz, L. Ming, R. Capasso
Abelmoschus esculentus (L.) Moench, commonly known as okra, is one of the most widely used vegetable crops currently used for diabetes treatment as well. It is thought that the large amount of soluble dietary fibers present in okra is responsible for the slowing of the absorption of glucose from the gut. However, its role in concomitant administration with commonly prescribed medications, including metformin (MET) and acarbose (ACR) for diabetes, is unclear. Therefore, this study assessed the effect of A. esculentus pod extract (AEE) administered concomitantly with MET and ACR in the glucose-induced hyperglycemic mice model. The AEE was prepared using green okra pods. In this experiment, each male Swiss Webster mouse was administered a 2.5 gm/kg/BW dose of glucose via gastric lavage to induce hyperglycemia. The experimental animals were divided into five groups: (i) negative control, (ii) positive control, (iii) MET only, (iv) MET and ACR, and (v) MET, ACR, and AEE. The orally administered doses of the MET, ACR, and the extract were 150 mg/kg/BW, 15 mg/kg/BW, and 0.2 mL/kg/BW, respectively. We found that MET only and a combination of MET and ACR reduced glucose levels significantly (p < 0.01) compared to the positive control. On the other hand, when MET, ACR, and AEE were administered simultaneously, the synergistic antihyperglycemic action of the MET and ACR was diminished. After 150 min, the blood glucose level was 4.50 ± 0.189 mmol/L (iv) and 6.58 ± 0.172 mmol/L (v). This study suggests that taking AEE concurrently with MET and ACR would reduce the effectiveness of antidiabetic drugs; thereby, concomitant administration of these antidiabetic agents is not recommended. This study provides an essential basis for decision-making about the consumption of AEE with conventional medicine. Further study is required to find the molecular insight of drug interactions in combination therapy of medicinal plants for diabetes.
绿毛鼠(L.)秋葵,俗称秋葵,是目前用于糖尿病治疗的最广泛使用的蔬菜作物之一。据认为,秋葵中存在的大量可溶性膳食纤维是减缓肠道对葡萄糖吸收的原因。然而,它在与常用处方药物(包括治疗糖尿病的二甲双胍(MET)和阿卡波糖(ACR))同时用药中的作用尚不清楚。因此,本研究评估了沙豆荚提取物(AEE)与MET和ACR同时给药对葡萄糖诱导的高血糖小鼠模型的影响。AEE采用绿色秋葵豆荚制备。在本实验中,每只雄性瑞士韦氏小鼠灌胃给予2.5 gm/kg/BW剂量的葡萄糖诱导高血糖。实验动物分为5组:(i)阴性对照组,(ii)阳性对照组,(iii)仅MET组,(iv) MET + ACR组,(v) MET + ACR + AEE组。MET、ACR和提取物的口服剂量分别为150 mg/kg/BW、15 mg/kg/BW和0.2 mL/kg/BW。我们发现,与阳性对照相比,仅MET和MET与ACR联合使用可显著降低血糖水平(p < 0.01)。另一方面,当MET、ACR和AEE同时使用时,MET和ACR的协同降糖作用减弱。150min后,血糖水平分别为4.50±0.189 mmol/L (iv)和6.58±0.172 mmol/L (v)。本研究提示AEE与MET、ACR同时服用会降低降糖药物的疗效;因此,不建议同时使用这些抗糖尿病药物。本研究为常规药物使用AEE的决策提供了重要依据。药用植物联合治疗糖尿病中药物相互作用的分子机制有待进一步研究。
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引用次数: 10
The Coming of Age of Biosimilars: A Personal Perspective 生物仿制药时代的到来:个人观点
Pub Date : 2022-04-20 DOI: 10.3390/biologics2020009
Sarfaraz K Niazi
Biosimilars have come of age over the past 17 years, with 84 approvals in the EU and 35 in the US, representing almost 90% of the world market. While the acceptance of biosimilars in the US is catching up with that in the EU, the cost benefits remain elusive due to the high development barrier and complex distribution system involved, mainly in the US. In the EU, the cost of biosimilars has already dropped 70% or more, and interchangeability is a routine in some European jurisdictions, unlike in the US, where a separate regulatory approval is required. This paper projects significant changes coming in the US and EU’s biosimilars approval requirements that will impact the approval procedures in the rest of the world, leading to dramatic changes in the cost of biosimilars to patients. This perspective is based on the author’s first-hand experience to secure FDA approvals of biosimilars and an extensive analysis of the rationality of testing to demonstrate biosimilarity. Multiple citizen petitions by the author and meetings with the FDA may have prompted the recent announcement by the FDA to award a $5 million research grant to scientists to develop novel testing models to establish biosimilarity, including modifying the interchangeability protocols. Soon, demonstration of biosimilarity will not require animal testing and, in most cases, clinical efficacy testing; over time, the clinical pharmacology testing will be reduced as the regulatory agencies develop more confidence in the safety and efficacy of biosimilars. Biosimilars have come of age; now it is the turn of the developers to grow up, and one way to show this is to challenge the current regulatory guidelines but only on scientific grounds to seek more concessions, for which both FDA and EMA are ready.
在过去的17年里,生物仿制药已经成熟,欧盟批准了84个,美国批准了35个,几乎占世界市场的90%。虽然美国对生物仿制药的接受程度正在赶上欧盟,但由于开发障碍高,涉及复杂的分销系统,成本效益仍然难以捉摸,主要是在美国。在欧盟,生物仿制药的成本已经下降了70%或更多,而且在一些欧洲司法管辖区,可互换性是一种常规,不像在美国,需要单独的监管批准。本文预测美国和欧盟的生物仿制药审批要求将发生重大变化,这将影响世界其他地区的审批程序,导致患者的生物仿制药成本发生巨大变化。这种观点是基于作者的第一手经验,以确保FDA批准生物仿制药和广泛的分析测试的合理性,以证明生物相似性。作者的多次公民请愿和与FDA的会议可能促使FDA最近宣布向科学家提供500万美元的研究资助,以开发新的测试模型,以建立生物相似性,包括修改互换性协议。很快,证明生物相似性将不需要动物试验,在大多数情况下,不需要临床疗效试验;随着时间的推移,随着监管机构对生物仿制药的安全性和有效性越来越有信心,临床药理学测试将会减少。生物仿制药已经成熟;现在轮到开发人员成长了,一种方法是挑战当前的监管指导方针,但只在科学的基础上寻求更多的让步,这是FDA和EMA都准备好的。
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引用次数: 14
Therapeutic Role of Antimicrobial Peptides in Diabetes Mellitus 抗菌肽在糖尿病中的治疗作用
Pub Date : 2022-03-18 DOI: 10.3390/biologics2010008
Julia Depta, P. Małkowska, M. Wysokińska, Karolina Todorska, Olga Sierawska, Rafał Hrynkiewicz, Dominika Bębnowska, P. Niedźwiedzka-Rystwej
Antimicrobial peptides (AMPs) have recently become widely publicized because they have the potential to function in alternative therapies as “natural” antibiotics, with their main advantage being a broad spectrum of activity. The potential for antimicrobial peptides to treat diabetes mellitus (DM) has been reported. In diabetes mellitus type I (T1D), cathelicidin-related antimicrobial peptide (CRAMP), cathelicidin antimicrobial peptide (CAMP) and mouse-β- defensin 14 (mBD14) are positively affected. Decreased levels of LL-37 and human neutrophil peptide 1-3 (HNP1-3) have been reported in diabetes mellitus type II (T2D) relative to healthy patients. Moreover, AMPs from amphibians and social wasps have antidiabetic effects. In infections occurring in patients with tuberculosis-diabetes or diabetic foot, granulysin, HNP1, HNP2, HNP3, human beta-defensin 2 (HBD2), and cathelicidins are responsible for pathogen clearance. An interesting alternative is also the use of modified M13 bacteriophages containing encapsulated AMPs genes or phagemids.
抗菌肽(AMP)最近被广泛宣传,因为它们有潜力作为“天然”抗生素在替代疗法中发挥作用,其主要优势是具有广谱活性。抗菌肽治疗糖尿病(DM)的潜力已被报道。在I型糖尿病(T1D)中,组织蛋白酶相关抗菌肽(CRAMP)、组织蛋白酶抗菌肽(CAMP)和小鼠-β-防御素14(mBD14)受到积极影响。据报道,与健康患者相比,II型糖尿病(T2D)中LL-37和人中性粒细胞肽1-3(HNP1-3)的水平降低。此外,两栖动物和群居黄蜂的AMPs具有抗糖尿病作用。在结核性糖尿病或糖尿病足患者中发生的感染中,颗粒溶素、HNP1、HNP2、HNP3、人β-防御素2(HBD2)和组织蛋白酶负责病原体清除。一种有趣的替代方案也是使用含有封装的AMPs基因或噬菌体的修饰的M13噬菌体。
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引用次数: 4
Toxicity Studies on Essential Oil from Phoenix dactylifera (L.) Seed in Wistar Rats 凤凰花精油的毒性研究Wistar大鼠种子
Pub Date : 2022-03-09 DOI: 10.3390/biologics2010006
O. Oluyele, M. Oladunmoye, Ayodele Oluwayemisi Ogundare
This study evaluated the toxicological effect of oral administration of Phoenix dactylifera seed essential oil (PDEO) in Wistar rats. PDEO was extracted through a steam-distillation technique. Acute toxicity study evaluated administration of a single dose of the oil in a group (n = 5) of rats followed by 24 h observation, for sub-acute toxicity evaluation, the animals were randomly divided into five groups (n = 3). Group 1 to 4 rats, respectively, received 62.5, 125, 250, and 500 mg/kg bw of PDEO for fourteen days, while the fifth group served as control. At the termination of the study, blood samples were obtained for biochemical and hematological analyses, while vital organs were histopathologically examined. Results from this study revealed no mortality or abnormal behavioral changes in the animals. A dose-related increase in bodyweight and hematological parameters was observed across the treated groups (p < 0.05). At a dosage of 500 mg/kg bw, PDEO caused slight elevation in biochemical marker levels and mild changes in histological architecture of liver and kidney of the test rats. This study revealed that PDEO exhibited significant hematopoietic attributes with no adverse effect on the experimental rats’ vital organs at concentrations below 500 mg/kg bw.
本研究评价了凤凰籽精油(PDEO)在Wistar大鼠体内的口服毒性作用。PDEO是通过蒸汽蒸馏技术提取的。急性毒性研究评估了在一组(n=5)大鼠中单剂量施用该油,然后进行24小时观察。对于亚急性毒性评估,将动物随机分为五组(n=3)。第1-4组大鼠分别接受62.5、125、250和500 mg/kg bw的PDEO 14天,而第五组作为对照。研究结束时,采集血样进行生化和血液学分析,同时对重要器官进行组织病理学检查。这项研究的结果显示,动物没有死亡或异常行为变化。在各治疗组中观察到体重和血液学参数的剂量相关增加(p<0.05)。在500 mg/kg bw的剂量下,PDEO导致试验大鼠的生化标志物水平轻微升高,肝脏和肾脏的组织学结构发生轻微变化。这项研究表明,在浓度低于500毫克/千克体重时,PDEO表现出显著的造血特性,对实验大鼠的重要器官没有不良影响。
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引用次数: 3
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Biologics (Basel, Switzerland)
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