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生物药物滥用倾向评估——并非所有分子都一样。

Abuse liability assessment for biologic drugs - All molecules are not created equal.

机构信息

Comparative Biology and Safety Sciences, Amgen, Inc., South San Francisco, CA, USA.

Preclinical Safety, Discovery Sciences Support, Merck & Co., Ltd., Kenilworth, NJ, USA.

出版信息

Regul Toxicol Pharmacol. 2018 Feb;92:165-172. doi: 10.1016/j.yrtph.2017.11.019. Epub 2017 Dec 2.

Abstract

The development of novel drug candidates involves the thorough evaluation of potential efficacy and safety. To facilitate the safety assessment in light of global increases in prescription drug misuse/abuse, health authorities have developed guidance documents which provide a framework for evaluating the abuse liability of candidate therapeutics. The guidances do not distinguish between small molecules and biologics/biotherapeutics; however, there are key differences between these classes of therapeutics which are important drivers of concern for abuse. An analysis of these properties, including ability to distribute to the central nervous system, pharmacokinetic properties (e.g., half-life and metabolism), potential for off-target binding, and the physiochemical characteristics of biologic drug products suggests that the potential for abuse of a biologic is limited. Many marketed antibodies and recombinant proteins have been associated with adverse effects such as headache and dizziness. However, biologics have not historically engendered the rapid-onset psychoactive effects typically present for drugs of abuse, thus further underscoring their low risk for abuse potential. The factors to be taken into consideration before conducting nonclinical abuse liability studies with biologics are described herein; importantly, the aggregate assessment of these factors leads to the conclusion that abuse liability studies are unlikely to be necessary for this class of therapeutics.

摘要

新型药物候选物的开发涉及对潜在疗效和安全性的全面评估。为了根据全球处方药物滥用/误用的增加来进行安全评估,卫生当局制定了指导文件,为评估候选治疗药物的滥用倾向提供了框架。这些指南并没有区分小分子药物和生物药物/生物疗法;然而,这些治疗方法之间存在关键差异,这些差异是引起滥用关注的重要因素。对这些特性的分析,包括向中枢神经系统分布的能力、药代动力学特性(例如半衰期和代谢)、潜在的脱靶结合以及生物药物产品的物理化学特性表明,生物制剂的滥用潜力有限。许多已上市的抗体和重组蛋白与头痛和头晕等不良反应有关。然而,生物制剂并没有产生通常存在于滥用药物中的快速发作的精神活性作用,这进一步强调了它们的滥用风险较低。本文描述了在进行生物制剂的非临床滥用倾向研究之前需要考虑的因素;重要的是,对这些因素的综合评估得出结论,认为对于这类治疗药物,滥用倾向研究可能没有必要。

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