An Overview of Biosimilars-Development, Quality, Regulatory Issues, and Management in Healthcare

Biological therapies have transformed high-burden treatments. As the patent and exclusivity period for biological medicines draws to a close, there is a possibility for the development and authorization of biosimilars. These products boast comparable levels of safety, quality, and effectiveness to their precursor reference products. Biosimilars, although similar to reference products, are not identical copies and should not be considered generic substitutes for the original. Their development and evaluation involve a rigorous step-by-step process that includes analytical, functional, and nonclinical evaluations and clinical trials. Clinical studies conducted for biosimilars aim to establish similar efficacy, safety, and immunogenicity, rather than demonstrating a clinical benefit, as with the reference product. However, although the current knowledge regarding biosimilars has significantly increased, several controversies and misconceptions still exist regarding their immunogenicity, extrapolation, interchangeability, substitution, and nomenclature. The development of biosimilars stimulates market competition, contributes toward healthcare sustainability, and allows for greater patient access. However, maximizing the benefits of biosimilars requires cooperation between regulators and developers to ensure that patients can benefit quickly from access to these new therapeutic alternatives while maintaining high standards of quality, safety, and efficacy. Recognizing the inherent complexities of comprehending biosimilars fully, it is essential to focus on realistic approaches, such as fostering open communication between healthcare providers and patients, encouraging informed decision-making, and minimizing risks. This review addresses the regulatory and manufacturing requirements for biosimilars and provides clinicians with relevant insights for informed prescribing.

Nanoclays for wound management applications

Nanotechnology has been comprehensively applied as a new approach to managing wound healing. Particularly, nanoclays are being used to improve traditional wound healing approaches or new therapies. Nanoclays are nanoscale aluminosilicates with remarkable intrinsic properties, including the capacity to promote hemostatic response, anti-inflammatory effects, angiogenesis, and re-epithelization. The main purpose of the present review is focusing on skin lesions, post-surgical wounds, burn wounds, and chronic ulcer skin wounds that can be treated using nanoclays, not only as vehicles for therapeutic molecules' efficacy improvement but also alone due to their native beneficial features. A systematic search of the PubMed, ScienceDirect, Scopus, Web of Science, and Google Scholar databases revealed several studies satisfying the purpose of our study. In addition, the selected keywords were used to refine the information. Non-planar hydrous phyllosilicates have been compared with other nanoclays considering their acute specific surface area and loading capacity are strongly influenced by their structure. Nanocomposites in the powder form may be directly incorporated in polymers to form gels, biofilms, and scaffolds that may be adjustable to wound sites. Also, nanoclays can be directly incorporated into polymer mats. Regarding hydrogels/films and mats, nanoclays can improve their mechanical strength, thermal stability, viscosity, and cohesive strength. Additionally, nanoclays are able to control drug release, as well as their skin bioavailability, and seem to be promising candidates to overcome cytotoxicity problems; further in vivo toxicity studies are required.

Application of nanotechnology in management and treatment of diabetic wounds

Diabetic wounds are one of the most common health problems worldwide, enhancing the demand for new management strategies. Nanotechnology, as a developing subject in diabetic wound healing, is proving to be a promising and effective tool in treatment and care. It is, therefore, necessary to ascertain the available and distinct nanosystems and evaluate their performance when topically applied to the injury site, especially in diabetic wound healing. Several active ingredients, including bioactive ingredients, growth factors, mesenchymal stem cells, nucleic acids, and drugs, benefit from improved properties when loaded into nanosystems. Given the risk of problems associated with systemic administration, the topical application should be considered, provided stability and efficacy are assured. After nanoencapsulation, active ingredients-loaded nanosystems have been showing remarkable features of biocompatibility, healing process hastening, angiogenesis, and extracellular matrix compounds synthesis stimulation, contributing to a decrease in wound inflammation. Despite limitations, nanotechnology has attracted widespread attention in the scientific community and seems to be a valuable technological ally in the treatment and dressing of diabetic wounds. The use of nanotechnology in topical applications enables efficient delivery of the active ingredients to the specific skin site, increasing their bioavailability, stability, and half-life time, without compromising their safety.