División de Farmacología y Evaluación Clínica, Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios, C/Campezo 1. Edificio 8, Planta 2 Oeste, 28022 Madrid, Spain.
Eur J Clin Pharmacol. 2013 May;69(5):1157-62. doi: 10.1007/s00228-012-1456-6. Epub 2012 Nov 30.
The objective of the study was to investigate the relative bioavailability between the generic tacrolimus products that are presently authorized in Spain by adjusted indirect comparison. This was based on demonstration of bioequivalence with the reference product (Prograf, Astellas Pharma), which makes these generic tacrolimus products prescribable, switchable and therapeutically equivalent to the reference product; yet, according to Spanish legislation, only prescribers can switch tacrolimus-containing products.
Data from independent bioequivalence studies that compare each generic product with the reference product were combined by adjusted indirect comparisons to investigate the relative bioavailability between generic drug products, since there is no direct bioequivalence study comparing generics to each other.
Eight generic tacrolimus products in the form of capsules are presently authorized in Spain, but only five are marketed. These eight products represent only three different generic product developments. One product is authorized with four different names/companies, while another is authorized under three different names/companies. The adjusted indirect comparisons between generic products show bioequivalence within the conventional 80-125 % confidence interval acceptance criteria for area under the curve (AUC) and maximum concentration (Cmax).
Not only are the generic products bioequivalent with the reference product, but also with each other.
本研究旨在通过调整后的间接比较,对目前在西班牙获得批准的通用他克莫司产品的相对生物利用度进行研究。这是基于与参比产品(Prograf,安斯泰来制药)的生物等效性证明,这些通用他克莫司产品可用于处方、可转换且与参比产品具有治疗等效性;然而,根据西班牙法规,只有处方医生可以转换含他克莫司的产品。
通过调整后的间接比较,合并了独立的生物等效性研究数据,这些研究将每种仿制药与参比产品进行比较,以研究仿制药产品之间的相对生物利用度,因为没有直接的生物等效性研究比较仿制药之间的相互作用。
目前在西班牙有八种胶囊形式的通用他克莫司产品获得批准,但只有五种产品上市。这八种产品仅代表三种不同的通用产品开发。一种产品有四个不同的名称/公司获得批准,另一种产品有三个不同的名称/公司获得批准。通用产品之间的调整后间接比较显示,在曲线下面积(AUC)和最大浓度(Cmax)的常规 80-125%置信区间接受标准内具有生物等效性。
不仅通用产品与参比产品具有生物等效性,而且与彼此之间也具有生物等效性。