Fiorino Gionata, Ananthakrishnan Ashwin, Cohen Russell D, Cross Raymond K, Deepak Parakkal, Farraye Francis A, Halfvarson Jonas, Steinhart A Hillary
IBD Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy.
Massachusetts General Hospital, Boston, MA 02114, USA.
J Clin Med. 2025 Feb 26;14(5):1561. doi: 10.3390/jcm14051561.
Data indicate that earlier initiation of anti-tumor necrosis factor alpha (anti-TNF-α) biologic medicines may prevent progression to irreversible bowel damage and improve outcomes for patients with inflammatory bowel disease (IBD), particularly Crohn's disease. However, the high cost of such therapies may restrict access and prevent timely treatment of IBD. Biosimilar anti-TNF-α medicines may represent a valuable opportunity for cost savings and optimized patient outcomes by improving access to advanced therapies and allowing earlier anti-TNF-α treatment initiation. Biosimilar anti-TNF-α medicines have been shown to offer consistent therapeutic outcomes to their reference medicines, yet despite entering the IBD treatment armamentarium over 10 years ago, their implementation in clinical practice remains suboptimal. Factors limiting the 'real' use of biosimilar anti-TNF-α medicines may include an ongoing lack of understanding and acceptance of biosimilars by both healthcare professionals (HCPs) and patients, as well as systemic factors such as formulary decisions outside of the control of the prescriber. In this review, an expert panel of gastroenterologists discusses HCP-level considerations to improve biosimilar anti-TNF-α utilization in IBD in order to support early anti-TNF-α initiation and maximize patient outcomes.
数据表明，更早开始使用抗肿瘤坏死因子α（抗TNF-α）生物药物可能会防止病情进展至不可逆的肠道损伤，并改善炎症性肠病（IBD）患者的治疗结果，尤其是克罗恩病患者。然而，此类疗法的高昂成本可能会限制其可及性，并阻碍IBD的及时治疗。生物类似药抗TNF-α药物可能是一个节省成本并优化患者治疗结果的宝贵机会，通过改善先进疗法的可及性并允许更早开始抗TNF-α治疗。生物类似药抗TNF-α药物已被证明能提供与参比药物一致的治疗效果，然而尽管它们在10多年前就已进入IBD治疗手段之列，其在临床实践中的应用仍未达到最佳状态。限制生物类似药抗TNF-α药物“实际”使用的因素可能包括医疗保健专业人员（HCPs）和患者持续缺乏对生物类似药的理解和接受，以及诸如处方医生无法控制的药品目录决策等系统性因素。在本综述中，一个胃肠病专家小组讨论了在IBD中提高生物类似药抗TNF-α利用率的HCP层面的考量因素，以支持尽早开始抗TNF-α治疗并使患者治疗结果最大化。
