伊马替尼仿制药与他克莫司仿制药生物等效性评价——基于生物等效性研究结果的间接比较

D. Goryachev, N. E. Uvarova
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引用次数: 0

摘要

非专利药在科学文献中被广泛讨论。它们的主要优势是在医疗实践中的高可用性,因为有可能显著降低开发人员的成本。在大多数情况下,非专利口服药物的有效性和安全性是根据其与参比药物生物等效性的可接受的药代动力学评价结果来确定的。然而,仿制药之间并没有直接比较,这就对仿制药互换性结论的有效性提出了质疑。本研究的目的是根据参比药生物等效性研究中获得的信息,通过仿制药AUC0-t和Сmax的比值来评价间接比较的结果。材料和方法:作者对含有一种活性药物成分的仿制药的生物等效性研究结果进行了间接比较。该分析基于过去7年处理伊马替尼和他克莫司产品风险/获益评估的生物等效性研究报告。结果:对伊马替尼产品几何平均比值90%置信区间的间接评估结果表明,46.7%的病例的区间超出了至少一个估计参数的一般接受范围(80 - 125%)。对于他克莫司产品,AUC0-t比值的间隔时间没有超过一般接受的限度(80 - 125%),但在10%的病例中发现Cmax比值存在差异。然而,当使用90 - 111%的较窄范围来评估AUC0-t比率时,90%的比较对不符合推荐标准。结论:因此,关于两种仿制药与参比品的生物等效性可接受程度的结论不能构成将这些仿制药视为临床等效的科学充分理由。
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Evaluation of Bioequivalence of Generic Imatinib Products and Generic Tacrolimus Products Based on Indirect Comparison of the Results of Their Bioequivalence Studies
Generic drugs are widely discussed in the scientific literature. Their key advantage is high availability in the medical practice due to the possibility of a significant reduction in developer costs. In most cases the efficacy and safety of generic oral drugs are confirmed based on the acceptable results of pharmacokinetic evaluation of their bioequivalence with the reference drug. However, generic drugs are not directly compared with one another, and this calls into question the validity of the conclusion about the interchangeability of the generic drugs.The aim of this study was to evaluate the results of indirect comparison of generic drugs by the ratios of their AUC0-t and Сmax based on the information obtained in bioequivalence studies involving the reference drug.Materials and methods: the authors performed an indirect comparison of the results of bioequivalence studies of generic drugs containing one active pharmaceutical ingredient. The analysis was based on bioequivalence study reports over the last 7 years dealing with risk/benefit assessment of imatinib and tacrolimus products.Results: the results of indirect assessment of 90 % confidence intervals of the ratios of imatinib products’ geometric means show that in 46.7 % of cases the intervals fall outside the generally accepted limits (80–125 %) for at least one of the estimated parameters. As for tacrolimus products, the intervals did not go beyond the generally accepted limits (80–125 %) for the AUC0-t  ratio, but a discrepancy was found in 10 % of cases for the Cmax ratio. However, when narrower limits of 90–111 % were used to assess the AUC0-t ratio, 90 % of the compared pairs did not meet the recommended standards. Conclusions: thus, conclusions on the acceptable degree of bioequivalence of two generic drugs to the reference product cannot constitute a scientifically sufficient reason for regarding these generic drugs as clinically equivalent.
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