Department of Pediatrics, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA.
Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Dig Dis. 2020 Nov;21(11):610-620. doi: 10.1111/1751-2980.12940. Epub 2020 Oct 18.
The advent of biologics has changed outcomes in many chronic conditions, including inflammatory bowel disease (IBD). Biologics have been used for the induction and remission of ulcerative colitis and Crohn's disease for almost two decades and are effective in patients who used to fail conventional treatment with steroids, immunomodulators. The use of biologics in the treatment of IBD has increased over the last few years, partly due to the rise in its incidence and the use of biologics as a first-line treatment in severe disease as well as in complicated diseases like penetrating/fistulating Crohn's disease. However, their use is associated with a significant burden to the society with respect to healthcare costs, resulting in the premature discontinuation of therapy in some patients, leading to exacerbations and complications. The introduction of biosimilars a decade ago seems to be a promising approach to reducing the costs related to therapy. Since their introduction, numerous studies conducted in adults and some in children show the efficacy of biosimilars with a similar side-effect profile to biologics. This review discusses the history of biosimilars in the treatment of IBD, enumerates several such studies and discusses the possibility of using biosimilars in the future.
生物制剂的出现改变了许多慢性疾病的结局，包括炎症性肠病（IBD）。生物制剂已被用于溃疡性结肠炎和克罗恩病的诱导缓解期近 20 年，并且对以前使用类固醇和免疫调节剂常规治疗失败的患者有效。近年来，生物制剂在 IBD 治疗中的应用有所增加，部分原因是其发病率的上升，以及在严重疾病和穿透性/瘘管性克罗恩病等复杂疾病中将生物制剂作为一线治疗药物的使用。然而，由于生物制剂治疗相关的医疗费用给社会带来了巨大负担，导致一些患者提前停止治疗，从而导致病情恶化和并发症。十年前生物类似药的问世似乎是降低治疗相关成本的一个有前途的方法。自引入以来，在成人和一些儿童中进行的大量研究表明，生物类似药具有与生物制剂相似的疗效和副作用特征。本文综述了生物类似药在 IBD 治疗中的历史，列举了几项此类研究，并讨论了未来使用生物类似药的可能性。
