1
|
Report on the Second PANLAR Review Course in Rheumatology. J Clin Rheumatol 2020; 26:33-36. [DOI: 10.1097/rhu.0000000000000915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
2
|
Steinberg J, Fragoso YD, Duran Quiroz JC, García JR, Guerra C, Rodriguez V, Carcamo Rodriguez C, Ciampi E, Correa-Diaz E, Macías M, Novarro N, Vizcarra D, Oehninger Gatti C, Orozco G, Carrá A. Practical Issues Concerning the Approval and Use of Biosimilar Drugs for the Treatment of Multiple Sclerosis in Latin America. Neurol Ther 2019; 8:207-214. [PMID: 31127566 PMCID: PMC6858893 DOI: 10.1007/s40120-019-0139-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Indexed: 11/26/2022] Open
Abstract
The use of biosimilar drugs for multiple sclerosis (MS) has become widespread in Latin America, with the goal of reducing costs of treatments, promoting the sustainability of healthcare systems, and improving patient access to these therapies. There is currently a need to define and comply with requirements to guarantee the efficacy, safety, and quality of these drugs. Thus, the objective of the present study was to compile up-to-date information from each Latin American country assessed on (a) approval of biosimilar drugs by regulatory agencies; (b) use of biosimilar drugs, pharmacovigilance plans, risk management; and (c) update in the knowledge on different molecules. To do so, a group of experts from Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, Uruguay, and Venezuela met to discuss the current situation regarding good practices and risks associated with the use of biosimilar drugs in their respective countries. Regulation, risk management plans, and pharmacovigilance in the whole continent must guide the strategies on the commercialization and access of biosimilar drugs and copies of complex molecules. Current regulations must be implemented for the registration of biosimilar drug products and complex molecules. It is paramount to ensure that new products follow the best quality standards at all stages beyond being safe and efficient. Uncontrolled interchangeability between original biological and biosimilar should be avoided. Latin America requires the implementation and full use of strong pharmacovigilance programs. National and multinational clinical studies are required to demonstrate the similarity in safety, efficacy, and immunogenicity profiles of complex molecules, as well as biological and biosimilar products. Plain language summary available for this article.
Collapse
Affiliation(s)
| | - Yara D Fragoso
- MS Reference Center, Universidade Metropolitana de Santos, MS and Headache Research, Santos, Brazil.
| | | | - Juan Raul García
- Unidad de Enfermedades Desmielinizantes Nivel Nacional, Bogotá, Colombia
| | | | | | | | - Ethel Ciampi
- Pontificia Universidad Catolica de Chile, Santiago, Chile
- Neurología, Hospital Dr. Sótero del Río, Santiago, Chile
| | | | - Miguel Macías
- Departamento de Neurociencias y Doctorado de Farmacologia, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
| | - Nelson Novarro
- Complejo Hospitalario Metropolitano, Caja de Seguro Social, Panama City, Panama
| | - Darwin Vizcarra
- Hypnos Instituto del Sueno, Clínica San Felipe, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Geraldine Orozco
- Hospital Patrocinio Peñuela Ruiz, Instituto Venezolano de los Seguros Sociales, Centro Especialidades San Sebastián, San Cristóbal, Táchira, Venezuela
| | - Adriana Carrá
- MS Section, Hospital Británico de CABA, Buenos Aires, Argentina
- Neurociencias, Fundación Favaloro-INECO, CABA, Buenos Aires, Argentina
| |
Collapse
|
3
|
The Breakthrough of Biosimilars: A Twist in the Narrative of Biological Therapy. Biomolecules 2019; 9:biom9090410. [PMID: 31450637 PMCID: PMC6770099 DOI: 10.3390/biom9090410] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/18/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022] Open
Abstract
The coming wave of patent expiries of first generation commercialized biotherapeutical drugs has seen the global market open its doors to close copies of these products. These near perfect substitutes, which are termed as “biosimilars”, do not need to undergo intense clinical trials for their approval. However, they are mandated to produce identical similarity from their reference biologics in terms of clinical safety and efficacy. As such, these biosimilar products promise to foster unprecedented access to a wide range of life-saving biologics. However, seeing this promise be fulfilled requires the development of biosimilars to be augmented with product trust, predictable regulatory frameworks, and sustainable policies. It is vital for healthcare and marketing professionals to understand the critical challenges surrounding biosimilar use and implement informed clinical and commercial decisions. A proper framework of pharmacovigilance, education, and scientific exchange for biologics and biosimilars would ensure a dramatic rise in healthcare access and market sustainability. This paper seeks to collate and review all relevant published intelligence of the health and business potential of biosimilars. In doing so, it provides a visualization of the essential steps that are required to be taken for global biosimilar acceptance.
Collapse
|
4
|
Castañeda-Hernández G, Sandoval H, Coindreau J, Rodriguez-Davison LF, Pineda C. Barriers towards effective pharmacovigilance systems of biosimilars in rheumatology: A Latin American survey. Pharmacoepidemiol Drug Saf 2019; 28:1035-1044. [PMID: 31148288 PMCID: PMC6771580 DOI: 10.1002/pds.4785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 01/12/2023]
Abstract
Purpose This review summarises the current status of regulatory guidelines for the approval of biosimilars in Latin America and highlights the main barriers to effective pharmacovigilance in this region. We also report results from a survey of Latin American rheumatologists assessing their understanding of prescribing biosimilars and the pharmacovigilance of these drugs. Methods We reviewed the current guidelines for the regulatory approval of biosimilars and barriers to effective pharmacovigilance in Latin American countries. Rheumatologists attending the II Pan‐American League of Rheumatology Associations PANLAR Review Course (Biosimilars update) in Lima, Peru were asked to complete a short survey to determine their knowledge of biosimilars. Results Many Latin American countries continue to lag behind Europe and the United States in establishing regulatory guidance and effective pharmacovigilance systems for biosimilars. Results from our survey also highlight a lack of awareness regarding the availability of biosimilars, their nomenclature, automatic substitution, and reporting adverse drug reactions because of these drugs. Conclusions The main barriers to effective pharmacovigilance in Latin America are the lack of consensus on the interchangeability of reference biologics and biosimilars, and the need for more suitably trained personnel to carry out effective postmarketing pharmacovigilance of biosimilars. Inconsistencies in biosimilar nomenclature make it difficult to adequately trace drugs and record adverse drug reactions associated with their use, creating a barrier to the global pharmacovigilance of biologics.
Collapse
Affiliation(s)
- Gilberto Castañeda-Hernández
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Hugo Sandoval
- Sociomedical Research Unit, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | | | | | - Carlos Pineda
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| |
Collapse
|
5
|
Ingrasciotta Y, Cutroneo PM, Marcianò I, Giezen T, Atzeni F, Trifirò G. Safety of Biologics, Including Biosimilars: Perspectives on Current Status and Future Direction. Drug Saf 2019; 41:1013-1022. [PMID: 29796832 DOI: 10.1007/s40264-018-0684-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In recent years, marketing of highly innovative and costly biologics improved the management of high-burden diseases such as autoimmune diseases, cancers, and chronic renal failure. Several widely prescribed biologics have recently lost or will shortly lose their patents, thus opening avenues to the marketing of a growing number of biosimilars worldwide, which are products similar in terms of quality, safety, and efficacy to already licensed reference products, thus allowing for potential savings in pharmaceutical expenditure. Numerous debates about the interchangeability between biosimilars and reference products are still ongoing, owing to concerns about potential immunogenicity raised by switching, which may cause a lack of effect and toxicity. Patients successfully treated with biologic therapy may theoretically receive biosimilars to contain costs, if reference product and related biosimilar are judged as interchangeable. However, the positions of regulatory agencies on the interchangeability and automatic substitution of biologics with biosimilars are very different. The benefit-risk profile of biosimilars has been often questioned by clinicians owing to the limited amount of pre-marketing information on clinical efficacy and safety, despite biosimilarity being based on a comparability exercise with the reference product to gain the biosimilar approval. Nevertheless, after more than 10 years of marketing from the first biosimilar approval in Europe, no proof of differences in terms of the safety profile of biosimilars and originators has been reported. In this context, post-marketing evaluation of both biologics and biosimilars safety profiles through analyses from spontaneous reporting databases and claims databases is crucial. An important issue for the pharmacovigilance of biologics concerns the traceability, indicating the brand name and batch number in spontaneous adverse drug reaction reports, but this requirement is not frequently addressed. This review aims to provide an overview of the characteristics and potential challenges in the safety profile assessment of biologics with a focus on the post-marketing setting.
Collapse
Affiliation(s)
- Ylenia Ingrasciotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, Messina, Italy
| | - Paola M Cutroneo
- Unit of Clinical Pharmacology, A.O.U. Policlinico "G. Martino", Messina, Italy.,Sicilian Regional Pharmacovigilance Center, Messina, Italy
| | - Ilaria Marcianò
- Unit of Clinical Pharmacology, A.O.U. Policlinico "G. Martino", Messina, Italy
| | - Thijs Giezen
- Foundation Pharmacy for Hospitals in Haarlem, Haarlem, The Netherlands
| | - Fabiola Atzeni
- Unit of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gianluca Trifirò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, Messina, Italy. .,Unit of Clinical Pharmacology, A.O.U. Policlinico "G. Martino", Messina, Italy.
| |
Collapse
|
6
|
Kowalski SC, Benavides JA, Roa PAB, Galarza-Maldonado C, Caballero-Uribe CV, Soriano ER, Pineda C, Azevedo VF, Avila-Pedretti G, Babini AM, Cachafeiro-Vilar A, Cifuentes-Alvarado M, Cohen SB, Díaz PE, Soto LD, Encalada C, Garro B, Sariego IAG, Guibert-Toledano M, Rodriguez VJK, Lopez MEL, Ortega AP, Russell AS, Santos-Moreno P, Terán IS, Vargas A, Vásquez G, Xavier RM, Firedman DXX, Mysler E, Kay J. PANLAR consensus statement on biosimilars. Clin Rheumatol 2019; 38:1485-1496. [DOI: 10.1007/s10067-019-04496-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/19/2019] [Accepted: 02/24/2019] [Indexed: 01/28/2023]
|
7
|
Esteban E, Bustos RH, García JC, Jáuregui E. Biosimilars: An Approach to some Current Worldwide Regulation Frameworks. ACTA ACUST UNITED AC 2019; 14:16-40. [DOI: 10.2174/1574884713666181025142928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/12/2018] [Accepted: 10/19/2018] [Indexed: 12/26/2022]
Abstract
Developing new biologics has led to regulations and norms aimed at guaranteeing their
safety, quality and effectiveness, in terms of marketing, prescription, use, interchangeability and
switching. Biologics are of great importance in treating patients suffering from rheumatic, autoimmune,
inflammatory and neoplastic diseases. The expiry/lapse of reference biologics or originators’
patents has meant that developing biosimilars involves accompanying legal requirements for their
approval in countries worldwide. This paper has thus approached the situation of biosimilar regulation
worldwide, the pertinent technical concepts and regulatory differences in some countries of
interest.
Collapse
Affiliation(s)
- Efraín Esteban
- Evidence-Based Therapeutic Group, Clinical Pharmacology, Universidad de la Sabana, Chia, Colombia
| | - Rosa-Helena Bustos
- Evidence-Based Therapeutic Group, Clinical Pharmacology, Universidad de la Sabana, Chia, Colombia
| | - Julio-César García
- Evidence-Based Therapeutic Group, Clinical Pharmacology, Universidad de la Sabana, Chia, Colombia
| | | |
Collapse
|
8
|
Azevedo VF, Babini A, Caballero-Uribe CV, Castañeda-Hernández G, Borlenghi C, Jones HE. Practical Guidance on Biosimilars, With a Focus on Latin America: What Do Rheumatologists Need to Know? J Clin Rheumatol 2019; 25:91-100. [PMID: 30059414 PMCID: PMC6392209 DOI: 10.1097/rhu.0000000000000881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/HISTORICAL PERSPECTIVE Availability of biologic disease-modifying antirheumatic drugs (bDMARDs) has improved clinical outcomes in rheumatoid arthritis, but it also increased the cost of treatment. Biosimilars, the regulated copies of biologic products, have a potential to reduce health care costs and expand access to treatment. However, because of a complex development process, biosimilars can be considered only those noninnovator biologics with satisfactory supporting evidence (ranging from structural to clinical), as outlined in the recommendations by the World Health Organization (WHO). In Latin America, a heterogeneous regulatory landscape and nonconsistent approval practices for biosimilars create decision-making challenges for practicing rheumatologists. SUMMARY OF LITERATURE Most Latin American countries either have adopted or are in the process of adopting guidelines for the approval of biosimilars. However, among several marketed bDMARDs in the region, currently there are only 2 products that could be considered true biosimilars, based on the WHO criteria. The rest can be considered only intended copies, whose safety and efficacy are not fully established. One such product had to be withdrawn from the market because of safety concerns. CONCLUSIONS AND FUTURE DIRECTIONS Practicing rheumatologists in Latin America need to understand the regulatory situation for biosimilars in their countries. When considering bDMARDs that are not innovator products, clinicians should use only those that have been approved according to the WHO recommendations. For clarification, local health authorities or professional associations should be contacted.
Collapse
|
9
|
Pineda C, Sandoval H, Fraga-Mouret A. Mexican rheumatology: where do we stand? Rheumatol Int 2018; 39:585-593. [PMID: 30421102 DOI: 10.1007/s00296-018-4198-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/02/2018] [Indexed: 12/16/2022]
Abstract
The aim of this review was to provide an overall overview of the past, present, and future situations and main challenges that are facing Mexican Rheumatology as a medical subspecialty in the context of their national healthcare system, where a deficit of workforce at the national level coexists with a shortage of specialists in the less-developed southern states of the country and a great surplus of professionals within large metropolitan areas. We also analyzed the prevalence and burden of Rheumatic and Musculoskeletal Diseases (RMDs), the structural composition and distribution of Mexican Rheumatology, and the clinical profile of the Mexican Rheumatologist. Last, we examined comorbidities, education and training programs and one scenario for Mexican Rheumatology wherein the principal main threats and opportunities are determined.
Collapse
Affiliation(s)
- Carlos Pineda
- Division of Musculoskeletal and Rheumatic Disorders, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Col. Arenal de Guadalupe, 14389, Tlalpan, Ciudad De México, México.
| | - Hugo Sandoval
- Division of Musculoskeletal and Rheumatic Disorders, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Col. Arenal de Guadalupe, 14389, Tlalpan, Ciudad De México, México
| | - Antonio Fraga-Mouret
- Saint Luke School of Medicine, Sierra Mojada 415, Col. Lomas de Chapultepec Secc. III, Miguel Hidalgo, 11000, Ciudad de México, México
| |
Collapse
|
10
|
Kos IA, Azevedo VF, Neto DE, Kowalski SC. The biosimilars journey: current status and ongoing challenges. Drugs Context 2018; 7:212543. [PMID: 30302115 PMCID: PMC6172013 DOI: 10.7573/dic.212543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 12/29/2022] Open
Abstract
Biosimilar products are already approved and marketed in several countries. The Food and Drug Administration has approved ten different biosimilars, and the European Medicines Agency has approved 40. Even though this scenario has provided important experience with biosimilar products, there are still challenges and unanswered questions. Up to now, a good amount of knowledge has been gathered in order to support the importance of the totality of evidence and the construction of a biosimilarity exercise for regulatory approval. In addition, the extrapolation of indications has been proved viable when a careful analysis is performed. The models for clinical trials and the use of the most sensible populations have been extensively discussed, and there is apparent homogeneity in manufacturer choices for study designs. However, some challenges remain. The lack of regulatory harmony, especially concerning naming, the marketed intended copies, the interchangeability, and the biosimilars in orphan diseases are some of those and are the focus of discussion in this review.
Collapse
Affiliation(s)
- Igor Age Kos
- Federal University of Paraná, Curitiba, Paraná, Brazil
- Edumed, Educação em Saúde, Curitiba, Paraná, Brazil
| | - Valderílio Feijó Azevedo
- Federal University of Paraná, Curitiba, Paraná, Brazil
- Edumed, Educação em Saúde, Curitiba, Paraná, Brazil
| | | | | |
Collapse
|
11
|
Scheinberg M, Pineda C, Castañeda-Hernández G, Zarbá JJ, Damião A, Arantes Jr LH, Jacobs I. Biosimilars in oncology and inflammatory diseases: current and future considerations for clinicians in Latin America. MAbs 2018; 10:827-842. [PMID: 30156950 PMCID: PMC6152448 DOI: 10.1080/19420862.2018.1484977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/21/2018] [Accepted: 06/01/2018] [Indexed: 02/06/2023] Open
Abstract
Biological therapies have revolutionized the treatment of several cancers and systemic immune-mediated inflammatory conditions. Expiry of patents protecting a number of biologics has provided the opportunity to commercialize highly similar versions, known as biosimilars. Biosimilars are approved by regulatory agencies via an independent pathway that requires extensive head-to-head comparison with the originator product. Biosimilars have the potential to provide savings to healthcare systems and expand patient access to biologics. In Latin American countries, regulatory frameworks for biosimilar approval have been introduced in recent years, and biosimilars of monoclonal antibody and fusion protein therapies are now emerging. However, the situation in this region is complicated by the presence of "non-comparable biotherapeutics" (also known as "intended copies"), which have not been rigorously compared with the originator product. We review the considerations for clinicians in Latin American countries, focusing on monoclonal antibody biosimilars relevant to oncology, rheumatology, gastroenterology, and dermatology.
Collapse
Affiliation(s)
- Morton Scheinberg
- Rheumatology Section – Orthopedics Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Carlos Pineda
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Gilberto Castañeda-Hernández
- Department of Pharmacology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan José Zarbá
- Oncology Department, Hospital Centro de Salud Zenón J. Santillán, San Miguel de Tucumán, Argentina
- Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
| | - Aderson Damião
- Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil
| | | | | |
Collapse
|
12
|
Trifirò G, Marcianò I, Ingrasciotta Y. Interchangeability of biosimilar and biological reference product: updated regulatory positions and pre- and post-marketing evidence. Expert Opin Biol Ther 2017; 18:309-315. [DOI: 10.1080/14712598.2018.1410134] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Gianluca Trifirò
- Unit of Clinical Pharmacology, A.O.U. Policlinico ‘‘G. Martino’’, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Ilaria Marcianò
- Unit of Clinical Pharmacology, A.O.U. Policlinico ‘‘G. Martino’’, Messina, Italy
| | - Ylenia Ingrasciotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| |
Collapse
|
13
|
Azevedo V, Dörner T, Strohal R, Isaacs J, Castañeda-Hernández G, Gonçalves J, McInnes I. Biosimilars: considerations for clinical practice. ACTA ACUST UNITED AC 2017. [DOI: 10.1136/conmed-2017-100005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
14
|
Abstract
This article summarizes the regulatory scenario on biological medications in Latin America focusing on comparability studies, extrapolation of indications, interchangeability and pharmacovigilance issues. In the case of comparability studies, what is being discussed is the possibility of decreasing the clinical trials requirement, but that the molecule should be well characterized in the studies of pharmacokinetics and pharmacodynamics. With the worldwide-level approval of the first monoclonal antibody biosimilar, infliximab, extrapolation of indications are being discussed, since the behavior of the Latin America regulatory agencies has been different with regard to such issue. Another issue discussed by the regulatory agencies is the interchangeability between biological medications and their biosimilars, mainly due to the fact that there is a clear confusion on interchangeability and substitution concepts. Finally, the pharmacovigilance debate, according to what takes place globally, is related to the need for identifying and differentiating the reference biological medication and its biosimilars for traceability purposes.
Collapse
Affiliation(s)
- Ricardo Garcia
- Latin American Center for Biological Research (CLAPBio), Rua São José, 696, Alto da Boa Vista, São Paulo, SP, Brazil, ZIP 04739-001.
| | - Denizar Vianna Araujo
- Internal Medicine Department at State University of Rio de Janeiro, Boulevard 28 de setembro 77, room 329, Vila Isabel, Rio de Janeiro, Brazil, ZIP 20551-030.
| |
Collapse
|
15
|
de la Cruz C, de Carvalho AVE, Dorantes GL, Londoño Garcia AM, Gonzalez C, Maskin M, Podoswa N, Redfern JS, Valenzuela F, van der Walt J, Romiti R. Biosimilars in psoriasis: Clinical practice and regulatory perspectives in Latin America. J Dermatol 2016; 44:3-12. [PMID: 27461455 DOI: 10.1111/1346-8138.13512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 05/30/2016] [Indexed: 11/28/2022]
Abstract
Latin American countries view biosimilar agents as an effective approach to curtail health-care expenditures while maintaining the safety and efficacy profile of their branded innovator comparators. To understand the complexities of the regulatory landscape and key therapeutic issues for use of biosimilars to treat moderate to severe psoriasis in Latin America, the International Psoriasis Council convened dermatology experts from Argentina, Brazil, Chile, Colombia and Mexico in October 2015 to review the definition, approval, marketing and future of biosimilars in each country and develop a consensus statement. The regulatory framework for marketing approval of biosimilars in Latin America is currently a mosaic of disparate, country-specific, regulatory review processes, rules and standards, with considerable heterogeneity in clarity and specificity. Regulations in Argentina, Brazil, Chile and Mexico have undergone multiple refinements whereas Colombia is finalizing draft guidelines. Verification of the similarity in quality, safety and efficacy of biosimilars to the innovator biologic remains a key challenge for policy makers and regulatory authorities. Other key regulatory challenges include: naming of agents and traceability, pharmacovigilance, extrapolation of indications, and interchangeability and substitution. An urgent need exists for more Latin American countries to establish national psoriasis registries and to integrate their common components into a multinational psoriasis network, thereby enhancing their interpretative power and impact. A Latin American psoriasis network similar to PSONET in Europe would assist health-care providers, pharmaceutical companies, regulators and patients to fully comprehend specific products being prescribed and dispensed and to identify potential regional trends or differences in safety or outcomes.
Collapse
Affiliation(s)
| | - André V E de Carvalho
- Dermatology Ambulatory, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | - Matías Maskin
- Department of Dermatology, CEMIC, Buenos Aires, Argentina
| | - Nancy Podoswa
- Department of Dermatology, HGR1 IMSS, Mexico City, Mexico
| | - Jan S Redfern
- Redfern Strategic Medical Communications, Springtown, Texas, USA
| | - Fernando Valenzuela
- Department of Dermatology, University of Chile and Probity Medical Research, Santiago, Chile
| | | | - Ricardo Romiti
- Department of Dermatology, Hospital das Clínicas University of São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
16
|
Swamy S, Mourya M, Kadhe G, Mane A, Sawant S. Safety reporting through a comprehensive and pragmatic pharmcovigilance process for India and emerging markets: an industry perspective. Expert Opin Drug Saf 2016; 14:1409-20. [PMID: 26292785 DOI: 10.1517/14740338.2015.1071792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Pharmacovigilance (PV) deals with the drug-related adverse reactions ensuring patients' safety. Emerging markets of India, South East Asia (SEA), Russia, Latin America (LA), Middle East and North Africa (MENA) have developed their own PV programs. However, under/manual reporting accompanied with lack of awareness regarding adverse drug reactions (ADRs) are major drawbacks that continue to exist due to lack of co-ordination and disparity in the regulatory approach. AREAS COVERED Of the 118 studies identified using various databases, 60 were included for the review. The authors discuss the present PV scenario of India, SEA, Russia, LA and MENA, and explain a basic process for uniform PV data input-output across industry, which includes data collection, analysis, processing, causality assessment and data distribution systems. EXPERT OPINION As the number of clinical trials conducted are rising in the emerging markets, there is a need to understand and implement a robust PV system, where electronically globalized, evidence based, public health oriented and regulatory compliant PV system is established. This would also improve transparency in system and ensure enhancement in safety data reporting ensuring premature and trouble-free detection of ADRs. It might result in implementing various PV boosting activities, which could yield robust patient safety data from India and emerging markets.
Collapse
Affiliation(s)
- Shashidhar Swamy
- a 1 Wockhardt Limited , Wockhardt Towers, Bandra Kurla Complex, Mumbai, India +91 99 20 168 771 ;
| | | | | | | | | |
Collapse
|
17
|
Olech E. Biosimilars: Rationale and current regulatory landscape. Semin Arthritis Rheum 2016; 45:S1-10. [DOI: 10.1016/j.semarthrit.2016.01.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/16/2015] [Accepted: 01/15/2016] [Indexed: 12/19/2022]
|
18
|
Mysler E, Pineda C, Horiuchi T, Singh E, Mahgoub E, Coindreau J, Jacobs I. Clinical and regulatory perspectives on biosimilar therapies and intended copies of biologics in rheumatology. Rheumatol Int 2016; 36:613-25. [PMID: 26920148 PMCID: PMC4839048 DOI: 10.1007/s00296-016-3444-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/12/2016] [Indexed: 02/07/2023]
Abstract
Biologics are vital to the management of patients with rheumatic and musculoskeletal diseases such as rheumatoid arthritis and other inflammatory and autoimmune conditions. Nevertheless, access to these highly effective treatments remains an unmet medical need for many people around the world. As patents expire for existing licensed biologic (originator) products, biosimilar products can be approved by regulatory authorities and enter clinical use. Biosimilars are highly similar copies of originator biologics approved through defined and stringent regulatory processes after having undergone rigorous analytical, non-clinical, and clinical evaluations. The introduction of high-quality, safe, and effective biosimilars has the potential to expand access to these important medicines. Biosimilars are proven to be similar to the originator biologic in terms of safety and efficacy and to have no clinically meaningful differences. In contrast, “intended copies” are copies of originator biologics that have not undergone rigorous comparative evaluations according to the World Health Organization recommendations, but are being commercialized in some countries. There is a lack of information about the efficacy and safety of intended copies compared with the originator. Furthermore, they may have clinically significant differences in formulation, dosages, efficacy, or safety. In this review, we explore the differences between biosimilars and intended copies and describe key concepts related to biosimilars. Familiarity with these topics may facilitate decision making about the appropriate use of biosimilars for patients with rheumatic and musculoskeletal diseases.
Collapse
Affiliation(s)
- Eduardo Mysler
- Reumatólogo en Organización Médica de Investigación, Buenos Aires, Argentina
| | - Carlos Pineda
- Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | | | | | | | - Javier Coindreau
- Pfizer Inc., 235 East 42nd Street, New York, NY, 10017-5755, USA
| | - Ira Jacobs
- Pfizer Inc., 235 East 42nd Street, New York, NY, 10017-5755, USA.
| |
Collapse
|
19
|
Recommendations on the use of biosimilars by the Brazilian Society of Rheumatology, Brazilian Society of Dermatology, Brazilian Federation of Gastroenterology and Brazilian Study Group on Inflammatory Bowel Disease—Focus on clinical evaluation of monoclonal antibodies and fusion proteins used in the treatment of autoimmune diseases. Autoimmun Rev 2015; 14:769-73. [DOI: 10.1016/j.autrev.2015.04.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/28/2015] [Indexed: 12/12/2022]
|
20
|
Dörner T, Kay J. Biosimilars in rheumatology: current perspectives and lessons learnt. Nat Rev Rheumatol 2015; 11:713-24. [PMID: 26282080 DOI: 10.1038/nrrheum.2015.110] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Biosimilars, based on biopharmaceuticals approved by regulatory agencies that are no longer under patent protection, have efficacy and safety comparable to their reference products, and are a new therapeutic option to treat inflammatory diseases. Biosimilars must be distinguished from 'biomimics' or 'biocopies', which are marketed in some countries but have not been evaluated according to the stringent regulatory pathway used for biosimilars. CT-P13, based on infliximab, was the first biosimilar approved for the treatment of inflammatory diseases; however, some countries did not allow extrapolation of indications to all eight diseases for which the reference drug infliximab is approved. Antidrug antibodies can reduce drug levels and affect clinical efficacy, but although available data suggest that biosimilars and their reference products have comparable immunogenicity, this important property might differ between individual biopharmaceuticals. This Review discusses biosimilars already approved within the past 3 years to treat rheumatic diseases, as well as others that are currently under development. The main challenges posed by biosimilars are also addressed, such as the extrapolation of indications to diseases only studied for the reference drug, and the definition of strategies for adequate pharmacovigilance to monitor biosimilars after marketing approval.
Collapse
Affiliation(s)
- Thomas Dörner
- Department of Medicine, Rheumatology and Clinical Immunology, Charite Universitätsmedizin and DRFZ Berlin, Chariteplatz 01, 10017 Berlin, Germany
| | - Jonathan Kay
- Division of Rheumatology, Department of Medicine, UMass Memorial Medical Centre and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA
| |
Collapse
|