Compliance Department, Amgen SAS, 92100 Paris, France.
Faculty of Pharmaceutical and Biological Sciences, University of Nantes, 44035 Nantes, France.
Int J Environ Res Public Health. 2020 Dec 29;18(1):186. doi: 10.3390/ijerph18010186.
Biologic reference drugs and their copies, biosimilars, have a complex structure. Biosimilars need to demonstrate their biosimilarity during development but unpredictable variations can remain, such as micro-heterogeneity. The healthcare community may raise questions regarding the clinical outcomes induced by this micro-heterogeneity. Indeed, unwanted immune reactions may be induced for numerous reasons, including product variations. However, it is challenging to assess these unwanted immune reactions because of the multiplicity of causes and potential delays before any reaction. Moreover, safety assessments as part of preclinical studies and clinical trials may be of limited value with respect to immunogenicity assessments because they are performed on a standardised population during a limited period. Real-life data could therefore supplement the assessments of clinical trials by including data on the real-life use of biosimilars, such as switches. Furthermore, real-life data also include any economic incentives to prescribe or use biosimilars. This article raises the question of relevance of automating real life data processing regarding Biosimilars. The objective is to initiate a discussion about different approaches involving Machine Learning. So, the discussion is established regarding implementation of Neural Network model to ensure safety of biosimilars subject to economic incentives. Nevertheless, the application of Machine Learning in the healthcare field raises ethical, legal and technical issues that require further discussion.
生物参考药物及其仿制药、生物类似药结构复杂,在开发过程中需要证明其生物相似性,但仍可能存在不可预测的变异,如微观异质性。医疗保健界可能会对这种微观异质性引起的临床结果提出质疑。事实上,由于产品变异等诸多原因,可能会引发不必要的免疫反应。然而,由于原因的多样性和任何反应之前可能存在的延迟,评估这些不必要的免疫反应具有挑战性。此外,作为临床前研究和临床试验一部分的安全性评估对于免疫原性评估可能价值有限,因为它们是在标准化人群中在有限的时间内进行的。因此,真实世界的数据可以通过包含生物类似药实际使用的数据(如转换)来补充临床试验的评估。此外,真实世界的数据还包括开具或使用生物类似药的任何经济激励措施。本文提出了关于自动化处理真实世界数据与生物类似药相关性的问题。目的是发起关于涉及机器学习的不同方法的讨论。因此,就神经网络模型的实施进行了讨论,以确保受经济激励的生物类似药的安全性。然而,机器学习在医疗保健领域的应用引发了伦理、法律和技术问题,需要进一步讨论。