Unit of Pediatric Gastroenterology and Cystic Fibrosis, Department of Human Pathology in Adulthood and Childhood 'G. Barresi', University of Messina, Messina, Italy.
J Clin Pharm Ther. 2020 Dec;45(6):1228-1234. doi: 10.1111/jcpt.13239. Epub 2020 Aug 2.
Based on extrapolation, biosimilar infliximab (IFX) was approved to treat inflammatory bowel disease (IBD). The first studies in adults have shown similar efficacy and safety in comparison with reference drug. The aim of this review was to collect and evaluate all the literature data regarding the use of biosimilar IFX in paediatric IBD.
This article reviewed efficacy, immunogenicity and safety profile of biosimilar IFX in IBD paediatric patients through a comprehensive search of the published literature.
Eight papers were extracted and critically reviewed. Four paediatric studies (prospective, n = 3; retrospective, n = 1) assessed the induction efficacy of the biosimilar IFX. Clinical response and remission rates reported were 86%-90% and 67%-68%, respectively. No significant difference in clinical response and remission rates between the reference and biosimilar IFX groups was found at follow-up (range: 3-13 months). Similar findings were shown in the prospective studies (n = 4) conducted on patients elected to switch from reference IFX to its biosimilar. The most frequently reported adverse events (AEs) of biosimilar IFX were mild upper respiratory tract infections. Taking into account of all AEs coming from published data, biosimilar IFX seems to be as safe as its originator. Immunogenicity has not been significantly impacted by the switch from the reference drug.
To date, treatment with (or switch to) biosimilar IFX in paediatric patients with IBD have been successful, without affecting efficacy, immunogenicity or safety. However, further studies are warranted, including clinical trials and pharmacovigilance studies.
基于推断,生物类似物英夫利昔单抗(IFX)被批准用于治疗炎症性肠病(IBD)。最初在成人中的研究表明,与参比药物相比,其疗效和安全性相似。本综述的目的是收集和评估所有关于生物类似物 IFX 在儿科 IBD 中应用的文献数据。
本文通过全面检索已发表的文献,综述了生物类似物 IFX 在 IBD 儿科患者中的疗效、免疫原性和安全性概况。
提取并批判性地评价了 8 篇论文。4 项儿科研究(前瞻性,n=3;回顾性,n=1)评估了生物类似物 IFX 的诱导疗效。报告的临床缓解率和缓解率分别为 86%-90%和 67%-68%。在随访期间(3-13 个月),未发现参考和生物类似物 IFX 组之间在临床缓解率和缓解率方面存在显著差异。在对选择从参考 IFX 转换为生物类似物的患者进行的 4 项前瞻性研究(n=4)中也观察到了类似的结果。生物类似物 IFX 最常报告的不良事件(AE)是轻度上呼吸道感染。考虑到所有来自已发表数据的 AE,生物类似物 IFX 似乎与原研药一样安全。免疫原性未因从参比药物转换而受到显著影响。
迄今为止,生物类似物 IFX 治疗(或转换为)儿科 IBD 患者已取得成功,不影响疗效、免疫原性或安全性。然而,还需要进一步的研究,包括临床试验和药物警戒研究。