Yokoo Masako, Kubota Yasushi, Tabe Yoko, Kimura Shinya
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University.
Biol Pharm Bull. 2015;38(3):411-6. doi: 10.1248/bpb.b14-00652. Epub 2015 Jan 8.
Long-term treatment with imatinib mesylate (IM) allows patients with chronic myeloid leukemia (CML) to live a near-normal lifespan. However, the fact that tyrosine kinase inhibitors, including IM, are extremely expensive is a major cause of poor adherence, resulting in disease relapse or drug resistance. Therefore, physicians are encouraged to prescribe generic drugs to reduce the financial burden of medical expenses. In Japan, only generic drugs that have a basic chemical structure and pharmacokinetic data that are the same as those of the original drug are approved. However, it is not mandatory to demonstrate that generic drugs have adequate biological effects. This is one of the reasons why Japanese hematologists do not often use generic IM. The aim of the present study was to compare the anti-leukemic effects of Glivec™ (a commercial IM) and its generic formulation, OHK9511. The IC50 values of OHK9511 and Glivec™ were comparable, and both induced similar levels of apoptosis in several CML cell lines. Furthermore, the overall survival of OHK9511-treated mice transplanted with BCR-ABL-positive cells was similar to that of mice treated with Glivec™. Although the experiments performed herein were basic, the results suggest that physicians should consider using generic IM.
甲磺酸伊马替尼(IM)的长期治疗可使慢性粒细胞白血病(CML)患者过上接近正常的寿命。然而,包括IM在内的酪氨酸激酶抑制剂极其昂贵,这是导致患者依从性差的主要原因,进而导致疾病复发或耐药。因此,鼓励医生开通用药物以减轻医疗费用的经济负担。在日本,只有基本化学结构和药代动力学数据与原研药相同的通用药物才被批准。然而,并不强制要求证明通用药物具有足够的生物学效应。这就是日本血液科医生不常使用通用IM的原因之一。本研究的目的是比较格列卫™(一种市售IM)及其通用制剂OHK9511的抗白血病作用。OHK9511和格列卫™的IC50值相当,并且在几种CML细胞系中诱导的凋亡水平相似。此外,移植了BCR-ABL阳性细胞并用OHK9511治疗的小鼠的总生存期与用格列卫™治疗的小鼠相似。尽管本文进行的实验较为基础,但结果表明医生应考虑使用通用IM。