School of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia.
Pharmacy Department, Chris O'Brien Lifehouse, Camperdown, NSW, 2006, Australia.
Ann Hematol. 2024 Nov;103(11):4607-4612. doi: 10.1007/s00277-024-05981-9. Epub 2024 Sep 9.
Unlike small molecule drugs and generic products, the active component of biologics and biosimilars are not identical chemical entities. Despite bioequivalence, there is limited evidence in clinical practice (i.e. Phase IV post-marketing surveillance) regarding the safety of biosimilar rituximab and even less so for "switching therapy" with respect to safety. Drug substitution by switching aims to realise cost savings by changing therapy involving a reference (biologic) product to a biosimilar. A retrospective analysis of safety outcomes including treatment-emergent adverse effects (TEAEs), rates of death and discontinuation of therapy, for all patients that received switching therapy (from reference to biosimilar rituximab, n = 33) was compared to patients who did not did not switch therapy (received biosimilar rituximab only, n = 18) at an Australian metropolitan cancer centre, over a six-month period. There was no statistical significant differences for any safety outcomes examined. Switching therapy for patients receiving rituximab does not lead to poorer safety outcomes.
与小分子药物和仿制药不同,生物制剂和生物类似药的活性成分并非完全相同的化学实体。尽管具有生物等效性,但在临床实践(即上市后第四阶段监测)中,关于生物类似药利妥昔单抗的安全性的证据有限,关于“转换治疗”的安全性证据则更少。通过转换进行药物替代的目的是通过改变涉及参照(生物)产品的治疗方法来节省成本,转而使用生物类似药。对澳大利亚大都市癌症中心的所有接受转换治疗的患者(从参照药转换为生物类似药利妥昔单抗,n=33)的安全性结果(包括治疗出现的不良反应[TEAEs]、死亡率和治疗中断率)进行了回顾性分析,与未接受转换治疗的患者(仅接受生物类似药利妥昔单抗治疗,n=18)进行了比较。在所有检查的安全性结果中,均无统计学显著差异。接受利妥昔单抗治疗的患者进行转换治疗不会导致安全性结果恶化。