Icahn School of Medicine at Mount Sinai, Dermatology, 1425 Madison Avenue, Box 1047, New York, NY, 10029-6574, U.S.A.
Albert Einstein College of Medicine, Department of Medicine, Division of Dermatology, Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, U.S.A.
Br J Dermatol. 2018 Apr;178(4):965-968. doi: 10.1111/bjd.15686. Epub 2018 Feb 7.
The advent of therapeutic antibodies, or biological medications, has transformed the treatment of many inflammatory diseases in dermatology. Recently, the development of biosimilars, biological drugs that are highly similar in quality, safety and efficacy to approved biologics, has changed this landscape. Although biosimilars are not identical to their reference product, they are required to have the same mechanism of action, route of administration, dosage form and strength as the reference product. This also leads to the possibility that subtle differences in the activity of these biosimilars can lead to differing clinical responses. We report the first case of a lichenoid eruption induced by a biosimilar to infliximab after switching from infliximab. Several days after initial infusion of the biosimilar, the patient developed a pruritic papulosquamous eruption that was biopsied to reveal a lichenoid drug eruption. Possible mechanisms for lichenoid drug eruptions as a result of tumour necrosis factor-α inhibitor administration are discussed, along with reasons why such a reaction may occur with a biosimilar but not the original, reference product. This case report calls attention to the unique differences between biosimilars and biological medications that a clinician should consider prior to prescribing these medications.
治疗性抗体（即生物药物）的出现改变了皮肤科许多炎症性疾病的治疗方式。最近，生物类似药的发展改变了这一局面，生物类似药在质量、安全性和疗效方面与已批准的生物制剂高度相似。尽管生物类似药与参比产品并不完全相同，但它们在作用机制、给药途径、剂型和强度方面必须与参比产品相同。这也导致这些生物类似药活性的细微差异可能导致不同的临床反应。我们报告了首例在从英夫利昔单抗转换为英夫利昔单抗生物类似药后，由生物类似药引起的类扁平苔藓样发疹。在首次输注生物类似药几天后，患者出现瘙痒性丘疹鳞屑性发疹，活检显示为类扁平苔藓样药物疹。讨论了由于肿瘤坏死因子-α抑制剂给药引起类扁平苔藓样药物疹的可能机制，以及为什么这种反应可能发生在生物类似药而不是原始参比产品上。本病例报告提请临床医生在开这些药物之前注意生物类似药和生物药物之间的独特差异。
