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这是值得担忧还是仅仅是炒作?——关于从原研生物药转换为生物类似药的临床后果的系统文献综述

Is there a reason for concern or is it just hype? - A systematic literature review of the clinical consequences of switching from originator biologics to biosimilars.

作者信息

Inotai András, Prins Christiaan P J, Csanádi Marcell, Vitezic Dinko, Codreanu Catalin, Kaló Zoltán

机构信息

a Syreon Research Institute , Budapest , Hungary.

b Department of Health Policy & Health Economics , Faculty of Social Sciences, Eötvös Loránd University (ELTE) Budapest , Hungary.

出版信息

Expert Opin Biol Ther. 2017 Aug;17(8):915-926. doi: 10.1080/14712598.2017.1341486. Epub 2017 Jun 26.

DOI:10.1080/14712598.2017.1341486
PMID:28650704
Abstract

While prescribing biosimilars to patients naive to a biologic treatment is a well-accepted practice, switching clinically stable patients from an originator to a biosimilar is an issue for clinicians. Well-designed clinical trials and real-world data which study the consequences of switching from an originator biologic treatment to its biosimilar alternative are limited, especially for monoclonal antibodies. Areas covered: A systematic literature review was conducted on PubMed to identify evidence of the consequences of switching from original biologics to biosimilars. References of included papers were also scrutinized. After a title-, abstract- and full text screening, out of the 153 original hits and 77 additional ones from screening the references, 58 papers (12 empirical papers, 5 systematic reviews and 41 non-empirical papers) were included. Expert opinion: Preventing patients on biologic medicines from switching to biosimilars due to anticipated risks seems to be disproportional compared to the expected cost savings and/or improved patient access. Indeed, it is the opinion of the authors that the concern of switching to biosimilars is overhyped.

摘要

虽然给未接受过生物治疗的患者开生物类似药是一种广泛认可的做法,但对于临床稳定的患者,从原研药转换为生物类似药对临床医生来说仍是个问题。关于从原研生物治疗转换为其生物类似药替代物后果的精心设计的临床试验和真实世界数据有限,尤其是对于单克隆抗体。涵盖领域:在PubMed上进行了系统的文献综述,以确定从原研生物药转换为生物类似药后果的证据。对纳入论文的参考文献也进行了审查。经过标题、摘要和全文筛选,在153条原始检索结果和通过参考文献筛选得到的77条额外结果中,共纳入了58篇论文(12篇实证论文、5篇系统评价和41篇非实证论文)。专家意见:与预期的成本节约和/或改善患者可及性相比,因预期风险而阻止使用生物药的患者转换为生物类似药似乎并不合理。事实上,作者认为对转换为生物类似药的担忧被过度夸大了。

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