a First Department of Medicine , Semmelweis University , Budapest , Hungary.
b Division of Gastroenterology , McGill University Health Center , Montreal , QC , Canada.
Expert Opin Biol Ther. 2018 Jun;18(6):633-640. doi: 10.1080/14712598.2018.1469620. Epub 2018 Apr 29.
Biological therapies have revolutionized the treatment of inflammatory bowel diseases (IBD) in the last two decades. Though biological drugs are effective, their use is associated with high costs and access to biological agents varies among countries. As the patent for the reference products expired, the advent of biosimilar monoclonal antibodies has been expected. Biosimilars represent less expensive alternatives compared to the reference product.
In this review, authors will review the literature on the clinical efficacy, safety and immunogenicity of current and future biosimilar infliximabs. Short- and medium-term data from real-life cohorts and from randomized-clinical trials in IBD demonstrated similar outcomes in terms of efficacy, safety and immunogenicity as the reference product for CT-P13. Switch data from the reference to the biosimilar product are also accumulating (including the NOR-SWITCH and the CT-P13 3.4 study).
The use of biosimilar infliximab in IBD is increasing worldwide. Its use may be associated with budget savings leading to better access to biological therapies and consequently improved health outcomes. Switching from the originator to a biosimilar in patients with IBD is acceptable, although scientific and clinical evidence is lacking regarding reverse switching, multiple switching, and cross-switching among biosimilars in IBD patients.
在过去的二十年中,生物疗法彻底改变了炎症性肠病(IBD)的治疗方法。尽管生物药物有效,但它们的使用与高成本相关,并且生物制剂的可及性在各国之间存在差异。随着参考产品专利的到期,人们期待着类似物单克隆抗体的出现。与参考产品相比,类似物代表了更经济的选择。
在这篇综述中,作者将回顾关于当前和未来的英夫利昔单抗类似物的临床疗效、安全性和免疫原性的文献。来自 IBD 的真实队列和随机临床试验的短期和中期数据表明,在疗效、安全性和免疫原性方面,类似物与参考产品 CT-P13 具有相似的结果。从参考产品到类似物产品的转换数据也在不断积累(包括 NOR-SWITCH 和 CT-P13 3.4 研究)。
在全球范围内,英夫利昔单抗类似物在 IBD 中的使用正在增加。其使用可能与预算节省相关,从而使更多患者能够获得生物疗法,进而改善健康结果。在 IBD 患者中从原创药转换为类似物是可以接受的,尽管关于反向转换、多次转换和 IBD 患者中类似物之间的交叉转换,目前缺乏科学和临床证据。