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Miao B, Isachkina AN, Shutov EV, Selyutin AA, Kvitkova LV, Shilo VY, Vetchinnikova ON, Alexandrov IV, Perlin DV, Zuev AV, Davydkin IL, Mironova TP, Solovyova OM, Tutin AP, Omelchenko AM, Vareesangthip K, Khadikova NG, Li M, Li X. Biosimilar erythropoietin in anemia treatment (BEAT)-Efficacy and safety of a 1:1 dose conversion from EPREX® to EPIAO® in patients with end-stage renal disease on hemodialysis: A prospective, randomized, double blind, parallel group study. Medicine (Baltimore) 2022; 101:e31426. [PMID: 36451454 PMCID: PMC9704908 DOI: 10.1097/md.0000000000031426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND EPREX®/ERYPO®/PROCRIT® (epoetin alfa, Janssen-Cilag GmbH) was the first available recombinant human erythropoietin (rHuEPO) and was universally reference product as per the recommendation provided by European Medicines Agency. EPIAO® is a biosimilar formulation of EPREX®, and making it a 1:1 dose conversion from EPREX® according to recommendation of European Medicines Agency. This study evaluated the clinical efficacy and safety of EPIAO® in subjects with end-stage renal disease receiving hemodialysis after intravenous administration. METHODS This study was a multicenter, prospective, randomized, double-blind, parallel-group, 2-cohort, maintenance phase, therapeutic equivalence study to evaluate a 1:1 dose conversion from EPREX® to EPIAO® in terms of clinical efficacy and safety that was conducted at 20 sites in 2 countries in patients with end-stage renal disease on hemodialysis. Eligible subjects were treated with EPREX® (reference product of epoetin) for a period of at least 3 months before the treatment period, and then were randomly assigned to the group of EPREX® or EPIAO®. Primary endpoints were mean absolute change in hemoglobin level and mean absolute change in weekly epoetin dosage from baseline to 6 months after treatment with EPIAO®/EPREX® in parallel groups. RESULTS A total of 200 people received the random intervention and were included in the safety set. After 6, 9, and 12 months of treatment with EPIAO® or EPREX®, there were no significant differences in the hemoglobin levels of the 2 groups compared with baseline. The 95% confidence interval for the treatment difference was within the predetermined acceptable range: ±0.5 g/dL. There were no significant differences in the epoetin dosage of the 2 groups compared with the baseline. The 95% confidence interval for the treatment difference was within the predetermined acceptable range: ± 45 IU/kg. There were no significant differences in the incidence of adverse events between the EPIAO® and EPREX® groups. Most adverse events were mild to moderate and were reverted/resolved. CONCLUSION EPIAO® demonstrated promising effectiveness and manageable safety in patients with end-stage renal disease on hemodialysis.
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Affiliation(s)
- Bolong Miao
- Medical Department, Shenyang Sunshine Pharmaceutical Co., Ltd., Shenyang Economy & Technology Department Zone, Shenyang, P.R.China
- * Correspondence: Bolong Miao, Medical Director, Medical Department, Shenyang Sunshine Pharmaceutical Co., Ltd., No. 3A1, Road 10, Shenyang Economy & Technology Department Zone 110027, P.R. China (e-mail: )
| | - Alina Nikolaevna Isachkina
- State Educational Government-Financed Institution of Higher Professional Education “North-Western State Medical University named after I.I. Mechnikov” of the Ministry of Health and Social Development of the Russian Federation, Clinical Hospital named after Peter the Great, dialysis department, Saint Petersburg, Russia
| | - Evgeny Viktorovich Shutov
- State Budgetary Institution of Health Care of the city of Moscow Municipal Clinical Hospital named after S.P. Botkin of the Department of Healthcare of the city of Moscow, Moscow, Russia
| | | | - Lyudmila Vladimirovna Kvitkova
- Autonomous Public Health Care Institution in the Kemerov region “S.V. Belyaev Kemerovo Regional Clinical Hospital,” Kemerovo City, Russia
| | - Valery Yuryevich Shilo
- Limited Liability Company “MEDITSYNSKY TSENTR VYSOKIKH TEKHNOLOGYII POLIKLINIKA No. 1 (Medical Center of High Technologies Policlinic No. 1”, Moscow, Russia
| | - Olga Nikolaevna Vetchinnikova
- State budgetary Healthcare Institution of the Moscow Region “Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy”, Surgical Nephrology and Hemocorrection Division, Chronic Hemodialysis Department, Moscow, Russia
| | | | - Dmitry Vladislavovich Perlin
- Budgetary Public Health Care Institution “Volgograd Regional Center for Urology and Nephrology”, Volzhsky City, Russia
| | - Alexander Vasilievich Zuev
- State Budgetary Healthcare Institution of the Republic of Karelia “V.A. Baranov Republican Hospital”, Petrozavodsk City, Russia
| | - Igor Leonidovich Davydkin
- State Educational Government-Financed Institution of Higher Professional Education “Samara State Medical University” of the Ministry of Health and Social Development of the Russian Federation, of the Clinic of the Samara State Medical University, the Clinic and Department of Hospital Therapy, dialysis department, Samara City, Russia
| | - Tatyana Pavlovna Mironova
- State Educational Government-Financed Institution of Higher Professional Education “Samara State Medical University” of the Ministry of Health and Social Development of the Russian Federation, of the Clinic of the Samara State Medical University, the Clinic and Department of Hospital Therapy, dialysis department, Samara City, Russia
| | - Olga Mikhailovna Solovyova
- Saint Petersburg State budget institution of healthcare “City hospital of Saint Martyr Elizabeth”, Saint Petersburg, Russia
| | - Alexey Pavlovich Tutin
- Limited Liability Company “Kupchinski tsentr ambulatornogo dializa”, Saint Petersburg, Russia
| | - Alexey Mikhailovich Omelchenko
- Saint Petersburg State-financed Health Institution “Municipal Mariinsky Hospital”, Dialysis Department, Saint Petersburg, Russia
| | - Kriengsak Vareesangthip
- Renal Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Man Li
- Project Manager, International Department, Shenyang Sunshine Pharmaceutical Co., Ltd., Beijing, P.R. China
| | - Xiang Li
- Medical Manager, Medical Department, Shenyang Sunshine Pharmaceutical Co., Ltd., Shenyang Economy & Technology Department Zone, Shenyang, P.R. China
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Mhiri A, Khemakhem M, Kalboussi N, Kacem B. [Knowledge and perceptions of biosimilar medicines by health professionals in Tunisia]. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:327-339. [PMID: 34428456 DOI: 10.1016/j.pharma.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/09/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Biosimilar drugs occupy a strategic place in the global pharmaceutical market. However, there are brakes on their use. The objective of our study is to assess the knowledge and perceptions of healthcare professionals on biosimilar drugs in a developing country. MATERIAL AND METHODS This is a prospective survey via an anonymous 18-question multiple-choice questionnaire developed and published online through the "Google Forms" application over a period of one month. This questionnaire is intended for Tunisian pharmacists and doctors of all ranks. RESULTS A total of 240 health professionals responded to this questionnaire, including 158 pharmacists and 82 physicians. Among them, 73 are not informed about the biosimilar drugs and were excluded from the rest of the questionnaire. Questions regarding the definition of biosimilar drugs and their differences from generic drugs obtained the best rate of 76 % of correct answers. In contrast, the questions that generated the most errors mainly concerned the regulation of biosimilar drugs. Participants felt that they were under-informed about biosimilar drugs in 65 % of the cases. In addition, 92 % were in favor of the development of this class of drugs and 85 % estimated significant to very significant savings related to their use. CONCLUSION Our study confirms the lack of information of pharmacists and physicians on biosimilar drugs. Sensitization of healthcare professionals on the safety and effectiveness of the use of these drugs seems to be necessary in order to allow their development.
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Affiliation(s)
- A Mhiri
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - M Khemakhem
- Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - N Kalboussi
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
| | - B Kacem
- Service de pharmacie, hôpital Sahloul de Sousse, Sousse, Tunisie; Faculté de pharmacie de Monastir, Monastir, Tunisie.
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Melosky B, Reardon DA, Nixon AB, Subramanian J, Bair AH, Jacobs I. Bevacizumab biosimilars: scientific justification for extrapolation of indications. Future Oncol 2018; 14:2507-2520. [PMID: 29690784 DOI: 10.2217/fon-2018-0051] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The first biosimilar of bevacizumab was approved by the US FDA; other potential biosimilars of bevacizumab are in late-stage clinical development. Their availability offers opportunity for increased patient access across a number of oncologic indications. The regulatory pathway for biosimilar approval relies on the totality of evidence that includes a comprehensive analytical assessment, and a clinical comparability study in a relevant disease patient population. Extrapolation of indications for a biosimilar to other eligible indications held by the originator, in the absence of direct clinical comparison, frequently forms part of the regulatory judgment. Herein, we consider the evidence required to demonstrate biosimilarity for bevacizumab biosimilars, with particular focus on the rationale for extrapolation across oncologic indications.
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Affiliation(s)
- Barbara Melosky
- Medical Oncology, British Columbia Cancer Agency, University of British Columbia, Vancouver, BC V5Z 4E6, Canada
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Andrew B Nixon
- Department of Medicine/Medical Oncology, Duke University School of Medicine, Durham, NC 27710, USA
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