Davis Gregory C, Beals John M, Johnson Craig, Mayer Mark H, Meiklejohn Bruce I, Mitlak Bruce H, Roth Jody L, Towns John K, Veenhuizen Melissa
Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, IN 46285, USA.
Curr Med Res Opin. 2009 Jul;25(7):1655-61. doi: 10.1185/03007990903017313.
Policy makers around the world are currently considering the creation of a regulatory pathway for follow-on biologics (FOB), which will have to account for the substantial technical challenges associated with FOB development. These challenges will likely involve more complexity than comparability assessments of process changes made by the same manufacturer. The history of industry-regulator comparability discussions helps explain why the same degree of testing and flexibility now applied to change-control within a manufacturer's own process, at this time, cannot be extrapolated to the observed and possibly unknown differences between two manufacturing processes that are independently developed by different (non-collaborating) parties.
This commentary provides recommendations on the technical aspects that should be considered in the creation of an approval pathway for FOB products.
In the authors' view, analytical methodology in its current state cannot alone provide full assurance that the FOB is sufficiently similar to the innovator product. Moreover, the FOB manufacturer will not have access to the extensive knowledge accumulated by the innovator manufacturer from early development through marketing. Thus, extensive clinical evaluation will likely be necessary to provide assurance that the FOB is safe and efficacious. If such testing demonstrates the FOB is safe and efficacious per existing regulatory standards, the product should receive marketing approval as a 'similar' product. Since 'similarity' is a fundamentally different determination than establishing interchangeability between the two products, an interchangeability determination must be based on additional testing and market experience to ensure patient safety. Post-marketing surveillance of the FOB should be conducted to ensure that the approved molecule has similar clinical safety and efficacy as the innovator product, prior to any consideration of interchangeability.
世界各地的政策制定者目前正在考虑为生物类似药建立一条监管途径,这将不得不考虑与生物类似药开发相关的重大技术挑战。这些挑战可能比同一制造商进行的工艺变更的可比性评估更为复杂。行业与监管机构可比性讨论的历史有助于解释为什么目前应用于制造商自身工艺变更控制的相同程度的测试和灵活性,此时不能外推到由不同(非合作)方独立开发的两种制造工艺之间已观察到的以及可能未知的差异。
本评论就生物类似药产品批准途径创建中应考虑的技术方面提供建议。
在作者看来,目前状态下的分析方法本身不能充分保证生物类似药与创新产品足够相似。此外,生物类似药制造商无法获取创新药制造商从早期开发到上市所积累的广泛知识。因此,可能需要进行广泛的临床评估,以确保生物类似药的安全性和有效性。如果此类测试证明生物类似药按照现有监管标准是安全有效的,该产品应作为“相似”产品获得上市批准。由于“相似性”与确定两种产品之间的可互换性有着根本不同的判定标准,可互换性判定必须基于额外的测试和市场经验,以确保患者安全。在考虑任何可互换性之前,应对生物类似药进行上市后监测,以确保获批分子与创新产品具有相似的临床安全性和有效性。