Zusammenfassung
Hintergrund
In diesem Artikel wird das Design klinischer Studien im Rahmen der Entwicklung von Biosimilars in Europa und in den USA vorgestellt, und es werden Erkenntnisse aus klinischen Studien mit Biosimilars für entzündlich bedingte Erkrankungen beleuchtet.
Methoden
Alle verfügbaren Informationen (Internet und PubMed) zur klinischen Entwicklung von Biosimilars für entzündliche Erkrankungen, insbesondere rheumatische Erkrankungen (u. a. rheumatoide Arthritis; Psoriasis; Psoriasisarthritis und Spondyloarthritiden) wurden zusammengestellt. Die Veröffentlichungen der European Medicines Agency (EMA) und der US Food and Drug Administration (FDA) wurden im Hinblick auf Empfehlungen zu Biosimilars durchsucht.
Ergebnisse
Die EMA hat bereits vor mehr als 10 Jahren Empfehlungen zur Entwicklung von Biosimilars veröffentlicht und mehrere Biosimilars zugelassen. Die FDA hat ebenfalls Empfehlungen zur präklinischen und klinischen Entwicklung von Biosimilars veröffentlicht. Bis zum Februar 2015 war jedoch noch kein Biosimilar entsprechend diesen Empfehlungen zugelassen.
Schlussfolgerung
Bestehen nach der präklinischen Entwicklung noch offene Fragen hinsichtlich der Vergleichbarkeit von „Biosimilar“ und Referenzprodukt, können diese ggf. in klinischen Studien beantwortet werden. Pharmakokinetische und pharmakodynamische Studien sind essenziell für die frühe klinische Entwicklung und weitere Phase-3-Studien. Weitere wichtige zu berücksichtigende Faktoren für Studien zu Biosimilars in der klinischen Entwicklung sind die Studienpopulation, das Studiendesign, Endpunkte, Größe der Stichprobe, Studiendauer und methodisch-analytische Fragen
Abstract
Background
This article presents the design of clinical trials for the development of biosimilars in the European Union and the United States, with special focus on inflammatory diseases.
Methods
All information available in PubMed and the Internet relating to the clinical development of biosimilars in inflammatory rheumatic conditions (e.g. rheumatoid arthritis, psoriasis, psoriatic arthritis and ankylosing spondylitis) was collated. The European Medicines Agency (EMA) and US Food and Drug Administration (FDA) websites were screened for guidelines on biosimilars.
Results
More than 10 years ago the EMA began to publish guidelines for the development of biosimilars and several biosimilars have now been approved. In the USA the FDA has published guidance for the nonclinical and clinical development of biosimilars but until early 2015 no biosimilar had been approved.
Conclusion
Clinical trials aim to resolve uncertainties that may remain following nonclinical development regarding the similarity of the proposed biosimilar with the reference product. Pharmacokinetic and pharmacodynamic studies are essential for early clinical development and further phase 3 clinical studies. Factors to be considered in the clinical process include study population, design, endpoints, sample size, duration and analytical methods.
Literatur
Patient Protection and Affordable Care Act. Congress of the United States (2010)
Colombel JF, Sandborn WJ, Reinisch W et al (2010) Infliximab, azathioprine, or combination therapy for Crohn’s disease. N Engl J Med 362:1383–1395
Dranitsaris G, Dorward K, Hatzimichael E et al (2013) Clinical trial design in biosimilar drug development. Invest New Drugs 31:479–487
Assessment report. Inflectra. European Medicines Agency. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_report/human/002778/WC500151490.pdf. Published 2013
European public assessment reports-Biosimilars. European Medicines Agency. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/landing/epar_search.jsp&mid=WC0b01ac058001d124&searchTab=searchByAuthType&keyword=Enter keywords&searchType=name&alreadyLoaded=true&status=Authorised&status=Withdrawn&status=Suspended&status=Refused&jsenabled=false&searchGenericType=biosimilars&orderBy=authDate&pageNo=1. Published 2014
Guideline on Similar Biological Medical Products Containing Biotechnology-Derived Proteins as Active Substance: Non-Clinical and Clinical Issues. European Medicines Agency. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2013/06/WC500144124.pdf. Published 2013
FDA accepts biosimilar filgrastim application. GaBI Online. http://www.gabionline.net/Biosimilars/News/FDA-accepts-biosimilar-filgrastim-application. Published 2014
Kay J, Smolen JS (2013) Biosimilars to treat inflammatory arthritis: the challenge of proving identity. Ann Rheum Dis 72:1589–1593
Klotz U, Teml A, Schwab M (2007) Clinical pharmacokinetics and use of infliximab. Clin Pharmacokinet 46:645–660
Landewe RBM, Van Der Heijde DMFM (2013) Clinical trial design and analysis. In: Firestein GS, Budd RC, Gabriel SE et al (Hrsg) Kelley’s textbook of rheumatology, 9. Aufl. Elsevier, Philadelphia, PA, 32-1-32-10
Lapadula G, Ferraccioli GF (2012) Biosimilars in rheumatology: pharmacological and pharmacoeconomic issues. Clin Exp Rheumatol 30:102–106
Park W, Hrycaj P, Jeka S et al (2013) A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study. Ann Rheum Dis 72:1605–1612
Rinaudo-Gaujous M, Paul S, Tedesco ED et al (2013) Review article: biosimilars are the next generation of drugs for liver and gastrointestinal diseases. Aliment Pharmacol Ther 38:914–924
Sandborn WJ, Feagan BG, Marano C et al (2014) Subcutaneous golimumab induces clinical response and remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology 146:85–95 (quiz e14–85)
Sandborn WJ, Feagan BG, Marano C et al (2014) Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology 146:96–109
Scheinberg MA, Kay J (2012) The advent of biosimilar therapies in rheumatology – „O brave new world“. Nature reviews. Rheumatology 8:430–436
Schett G, Elewaut D, Mcinnes IB et al (2013) How cytokine networks fuel inflammation: toward a cytokine-based disease taxonomy. Nat Med 19:822–824
Strand V, Cronstein B (2014) Biosimilars: how similar? Intern Med J 44:218–223
Strober BE, Armour K, Romiti R et al (2012) Biopharmaceuticals and biosimilars in psoriasis: what the dermatologist needs to know. J Am Acad Dermatol 66:317–322
Guidance for Industry. Clinical pharmacology data to support a demonstration of biosimilarity to a reference product. US Food and Drug Administration. http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm397017.pdf. Published 2014
Guidance for Industry. Formal meetings between the FDA and biosimilar biological product sponsors or applicants. US Food and Drug Administration. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM345649.pdf. Published 2013
Guidelines on Evaluation of Similar Biotherapeutic Products (SBPs). World Health Organization. http://www.who.int/biologicals/areas/biological_therapeutics/BIOTHERAPEUTICS_FOR_WEB_22APRIL2010.pdf. Published 2009
Guidance for Industry. Adaptive design clinical trials for drugs and biologics. US Food and Drug Administration. http://www.fda.gov/downloads/Drugs/.../Guidances/ucm201790.pdf. Published 2010
Guidance for Industry. Non-inferiority clinical trials. US Food and Drug Administration. http://www.fda.gov/downloads/Drugs/Guidances/UCM202140.pdf. Published 2010
Velengtas P, Mohr P, Messner DA (2012) National Pharmaceutical Council. Making informed decisions: assessing the strengths and weaknesses of study designs and analytic methods for comparative effectiveness research. http://www.npcnow.org/system/files/research/download/experimental_nonexperimental_study_final.pdf
Visser J, Feuerstein I, Stangler T et al (2013) Physicochemical and functional comparability between the proposed biosimilar rituximab GP2013 and originator rituximab. BioDrugs 27:495–507
Yoo DH, Hrycaj P, Miranda P et al (2013) A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Ann Rheum Dis 72:1613–1620
Einhaltung ethischer Richtlinien
Interessenkonflikt. R. Alten gibt an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Alten, R. Biosimilars in der Rheumatologie. Z Rheumatol 74, 682–688 (2015). https://doi.org/10.1007/s00393-014-1487-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00393-014-1487-8
Schlüsselwörter
- Entzündliche Erkrankungen
- Rheumatische Erkrankungen
- Therapeutische Äquivalenz
- European Medicines Agency
- Food and Drug Administration