Biological products or biopharmaceuticals are medicinal products derived from living systems and manufactured by modern biotechnological methods that differ widely from the traditional synthetic drugs. Monoclonal antibodies are the most rapidly growing type of biologic. They are much larger and more complex molecules with inherent diversity; therefore, different manufacturers cannot produce identical biological products, even with the same type of host expression system and equivalent technologies. Thus, legal follow-on biologics manufactured and marketed after patent expiration are usually referred to as biosimilars. Biosimilarity is based on a comparability exercise whereby unavoidable clinical differences are evaluated and must meet equivalence or non-inferiority criteria. Biosimilars need to comply with different regulatory requirements for market authorization in different sites. There are several other related issues that need to be defined by the national authorities, such as interchangeability, labeling and prescribing information. The Brazilian health surveillance agency follows the key principles established by the World Health Organization for the assessment of biosimilarity, although does not adopt the name 'biosimilar'. However, the agency also made a compromise on a standalone application pathway that does not require the usual comparability exercise with the reference product, originating nonbiosimilar copies. Interchangeability and the use of nonproprietary names are not regulated, giving rise to pressures on physicians and conflicts of interest in the decision making on biosimilar use. The scope of this article is to present the Brazilian regulation on biosimilars, its strengths and weaknesses, and to discuss it in the face of regulations in the USA and Europe.

译文

:生物产品或生物药品是衍生自生命系统并通过现代生物技术方法制造的药品,与传统的合成药物大不相同。单克隆抗体是生物增长最快的类型。它们是更大,更复杂的分子,具有固有的多样性。因此,即使使用相同类型的宿主表达系统和等效技术,不同的制造商也无法生产相同的生物产品。因此,专利到期后生产和销售的合法后续生物制剂通常被称为生物仿制药。生物相似性基于可比性演习,在该演习中必须评估不可避免的临床差异,并且必须符合等效性或非劣效性标准。生物仿制药需要遵守不同监管要求,以在不同地点进行市场授权。国家主管部门还需要定义其他一些相关问题,例如互换性,标签和处方信息。巴西卫生监督局遵循世界卫生组织为评估生物相似性而确立的关键原则,尽管未采用“生物相似性”这一名称。但是,该机构还对独立的应用途径做出了妥协,该途径不需要与非生物仿制药的参考产品进行通常的可比性测试。互换性和非专有名称的使用不受管制,这给医师带来了压力,并在生物仿制药使用的决策中产生了利益冲突。本文的范围是介绍巴西关于生物仿制药的法规,其优缺点,并与美国和欧洲的法规进行讨论。

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