Buyukavci Mustafa, Yildirim Zuhal Keskin
Department of Pediatric Oncology, Atatürk University School of Medicine, Erzurum, Turkey.
Eurasian J Med. 2019 Jun;51(2):112-115. doi: 10.5152/eurasianjmed.2018.18030.
In adults and children, the duration of chemotherapy-induced neutropenia and associated complications has decreased because of the prophylactic use of granulocyte colony-stimulating factors (G-CSFs). Biosimilar G-CSFs can play an important role in reducing treatment costs in daily practice. However, some concerns regarding the efficacy and safety of new biosimilar products exist among clinicians. This study compared the efficacy and safety of original and biosimilar filgrastims for the prophylaxis of chemotherapy-induced neutropenia in children.
Thirty children receiving myelosuppressive chemotherapy were enrolled in this study. Filgrastims (5 μg/kg/day) were subcutaneously administered in Group A (biosimilar, Leucostim®; Dem İlaç) and Group B (original drug, Neupogen®; Roche). Hemoglobin, white blood cell (WBC) count, platelet count, transfusion requirements, duration of hospitalization, and frequency and duration of adverse events including fever, neutropenia, and mucositis were evaluated following 25 treatment cycles in both groups.
The hemoglobin value, WBC count, and platelet count on days 1, 5, and 10, and the red blood cell and platelet transfusion requirements, frequency, duration, and severity of mucositis, and durations of fever, febrile neutropenia, and hospitalization were similar in both groups. Although the mean WBC counts on days 1 and 5 were lower in Group A, the difference was statistically insignificant.
The biosimilar filgrastim, Leucostim, is as effective and safe as the original drug for prophylaxis of chemotherapy-induced neutropenia in children.
在成人和儿童中,由于预防性使用粒细胞集落刺激因子(G-CSF),化疗引起的中性粒细胞减少症的持续时间及相关并发症有所减少。生物类似药G-CSF在降低日常治疗成本方面可发挥重要作用。然而,临床医生对新型生物类似药产品的疗效和安全性存在一些担忧。本研究比较了原研和生物类似药非格司亭预防儿童化疗引起的中性粒细胞减少症的疗效和安全性。
本研究纳入了30名接受骨髓抑制化疗的儿童。A组(生物类似药,Leucostim®;Dem İlaç)和B组(原研药,Neupogen®;罗氏)皮下注射非格司亭(5μg/kg/天)。在两组进行25个治疗周期后,评估血红蛋白、白细胞(WBC)计数、血小板计数、输血需求、住院时间以及包括发热、中性粒细胞减少和粘膜炎在内的不良事件的频率和持续时间。
两组在第1、5和10天的血红蛋白值、WBC计数和血小板计数,以及红细胞和血小板输血需求、粘膜炎的频率、持续时间和严重程度,以及发热、发热性中性粒细胞减少和住院时间均相似。虽然A组第1天和第5天的平均WBC计数较低,但差异无统计学意义。
生物类似药非格司亭Leucostim在预防儿童化疗引起的中性粒细胞减少症方面与原研药一样有效且安全。