Zheng Michael K, Shih David Q, Chen Gary C
Michael K Zheng, David Q Shih, F. Widjaja Foundation, Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States.
World J Gastroenterol. 2017 Mar 21;23(11):1932-1943. doi: 10.3748/wjg.v23.i11.1932.
Biologic therapy, such as those that target tumor necrosis factor (TNF) signaling, has proven to be an efficacious method of treatment for patients with inflammatory bowel disease (IBD) with regards to symptom management and mucosal healing. However, the rising prevalence of IBD worldwide and the ever-increasing burden of biologic pharmaceuticals in the health care industry is alarming for insurance companies, clinicians, and patients. The impending patent expiry and the relatively high costs of biologics, particularly anti-TNF agents, have paved the way for biosimilar development for IBD. The United States Food and Drug Administration defines a biosimilar as a biological product that is highly similar to its reference medicinal product, with no clinically meaningful differences in terms of safety, purity, and potency. The hope with biosimilars is that their entry into the market will be able to drive competition between pharmaceutical companies to reduce prices like that of the generic market, and that access to appropriate biologic treatments for IBD patients is increased in the long-term. Yet, there are challenging issues such as indication extrapolation and interchangeability that are still being debated in the field of IBD and must be addressed in future issued guidance. This review will discuss the issues and implications concerning the use of biosimilar therapy for IBD.
生物疗法,例如那些针对肿瘤坏死因子(TNF)信号传导的疗法,已被证明是治疗炎症性肠病(IBD)患者症状管理和黏膜愈合方面的有效方法。然而,IBD在全球范围内的患病率不断上升,以及生物制药在医疗保健行业日益增加的负担,这对保险公司、临床医生和患者来说都令人担忧。生物制剂即将到期的专利以及相对较高的成本,尤其是抗TNF药物,为IBD生物类似药的开发铺平了道路。美国食品药品监督管理局将生物类似药定义为与其参照药品高度相似的生物制品,在安全性、纯度和效力方面没有临床意义上的差异。生物类似药的期望在于其进入市场将能够推动制药公司之间的竞争,以降低价格,如同仿制药市场那样,并从长远来看增加IBD患者获得适当生物治疗的机会。然而,仍有一些具有挑战性的问题,如适应症外推和可互换性,在IBD领域仍在讨论中,并且必须在未来发布的指南中加以解决。本综述将讨论关于IBD生物类似药治疗使用的问题和影响。