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炎症性肠病中的生物类似药——不断积累的临床证据

Biosimilars in Inflammatory Bowel Disease - Accumulating Clinical Evidence.

作者信息

McConachie Sean, Wilhelm Sheila M, Kale-Pradhan Pramodini B

机构信息

a Department of Pharmacy , Harper University Hospital , Detroit , MI , USA.

b Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences , Wayne State University , Detroit , MI , USA.

出版信息

Expert Rev Clin Pharmacol. 2017 Apr;10(4):391-400. doi: 10.1080/17512433.2017.1283983. Epub 2017 Jan 29.

Abstract

Biologic antagonists to tumor necrosis factor alpha (TNF- α) are effective medications and have become well established in the treatment of both Crohn's disease and ulcerative colitis. Biosimilar medications, which are medications deemed to be equivalent to reference biologic products in terms of clinical effectiveness, safety, pharmacokinetic analysis, and immunogenicity, have now been approved in inflammatory bowel diseases (IBD) based on indication exploration from clinical data in alternate disease states. Clinicians use these products with caution secondary to lack of clinical experience. Areas Covered: The authors performed a literature search using the following keywords: CT-P13, biosimilar, adalimumab, infliximab, ABP 501, and inflammatory bowel disease. Bibliographies were also reviewed for pertinent articles. Articles pertaining to the clinical efficacy of biosimilars in IBD were included. Expert commentary: The phase 3 trials, which provided the clinical justification to bring TNF- α biosimilars to market, were in rheumatoid arthritis and ankylosing spondylitis; however, new clinical data suggests that biosimilar products have equivalent safety and efficacy to reference products in IBD. This has led to an increased acceptance amongst practicing gastroenterologists and a potential reduction in healthcare costs.

摘要

肿瘤坏死因子α(TNF-α)生物拮抗剂是有效的药物,已在克罗恩病和溃疡性结肠炎的治疗中得到广泛应用。生物类似药在临床有效性、安全性、药代动力学分析和免疫原性方面被认为与参照生物制品等效,目前已根据其他疾病状态的临床数据进行适应症探索,在炎症性肠病(IBD)中获得批准。由于缺乏临床经验,临床医生谨慎使用这些产品。涵盖领域:作者使用以下关键词进行了文献检索:CT-P13、生物类似药、阿达木单抗、英夫利昔单抗、ABP 501和炎症性肠病。还查阅了相关文章的参考文献目录。纳入了与生物类似药在IBD中的临床疗效相关的文章。专家评论:为TNF-α生物类似药上市提供临床依据的3期试验是在类风湿性关节炎和强直性脊柱炎中进行的;然而,新的临床数据表明,生物类似药产品在IBD中的安全性和疗效与参照产品相当。这导致执业胃肠病学家对其接受度增加,并可能降低医疗成本。

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