Kessler Michele, Goldsmith David, Schellekens Huub
Service de Néphrologie, Hôpitaux de Brabois, CHU de Nancy, 54500 Vandoeuvre les Nancy, France.
Nephrol Dial Transplant. 2006 Oct;21 Suppl 5:v9-12. doi: 10.1093/ndt/gfl476.
The availability of biopharmaceuticals has been increasing over the past decade and as their patents expire, the emergence of biosimilar agents approaches. The primary issue of concern for the safety of these agents is the potential for immunogenicity. Both product- and host-related factors have documented impact on the immune response, but many factors are still unknown. Although in many cases the presence of antibodies may have little clinical consequence, the upsurge of pure red cell aplasia cases further increased concerns about potential clinical consequences of extensive use of biopharmaceuticals and biosimilars. Available laboratory measurement methods are insufficient to predict biological and clinical properties of biopharmaceuticals, or even to compare their bioequivalence. Comparison of results from different studies is complicated by the variability of assay measurements, presentation of data and lack of standardization.
在过去十年中,生物制药的可及性一直在增加,随着其专利到期,生物类似药即将出现。这些药物安全性方面的主要问题是免疫原性的可能性。产品相关因素和宿主相关因素均已证明对免疫反应有影响,但许多因素仍不清楚。尽管在许多情况下,抗体的存在可能几乎没有临床后果,但纯红细胞再生障碍性贫血病例的激增进一步增加了人们对广泛使用生物制药和生物类似药潜在临床后果的担忧。现有的实验室测量方法不足以预测生物制药的生物学和临床特性,甚至无法比较它们的生物等效性。不同研究结果的比较因测定方法的可变性、数据呈现方式以及缺乏标准化而变得复杂。