Lavalle-González Fernando J, Khatami Hootan
Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
Postgrad Med. 2014 Oct;126(6):81-92. doi: 10.3810/pgm.2014.10.2823.
Biosimilar insulins have the potential to increase access to treatment among patients with diabetes mellitus, reduce treatment costs, and expand market competition. The patents for several insulins are soon to expire, meaning there is room for copies of these products--or 'biosimilars'--to join the marketplace. It is vital that similar safety and efficacy to the innovator product is demonstrated for biosimilars. This presents many possible manufacturing and regulatory challenges. Complex manufacturing processes mean that even small differences between manufacturers can have a potential impact on the final product. Several companies are currently developing biosimilar insulins or are already producing these products in emerging markets with different regulatory requirements. For insulin biosimilars to be licensed in more established markets, manufacturers will need to meet the rigid criteria set out by agencies such as the European Medicines Agency and US Food and Drug Administration, and fulfill several pre-clinical, clinical, and pharmacovigilance surveillance criteria. As a result of differing regulatory requirements, there are possible gaps in the publically available clinical data to support the safety and efficacy of biosimilar insulins from around the world current as of July 2014. This review summarizes the current biosimilar insulin landscape.
生物类似物胰岛素有潜力增加糖尿病患者获得治疗的机会,降低治疗成本,并扩大市场竞争。几种胰岛素的专利即将到期,这意味着这些产品的仿制品——即“生物类似物”——有进入市场的空间。证明生物类似物与创新产品具有相似的安全性和有效性至关重要。这带来了许多可能的生产和监管挑战。复杂的生产工艺意味着即使制造商之间的细微差异也可能对最终产品产生潜在影响。目前有几家公司正在研发生物类似物胰岛素,或者已经在具有不同监管要求的新兴市场生产这些产品。要使胰岛素生物类似物在更成熟的市场获得许可,制造商需要满足欧洲药品管理局和美国食品药品监督管理局等机构制定的严格标准,并满足多项临床前、临床和药物警戒监测标准。由于监管要求不同,截至2014年7月,全球公开可用的临床数据可能存在空白,无法支持生物类似物胰岛素的安全性和有效性。本综述总结了当前生物类似物胰岛素的情况。