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The role of biosimilars in the treatment of rheumatic diseases

Lookup NU author(s): Professor John Isaacs

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Abstract

The first biological therapeutics in rheumatology are approaching patent expiration, encouraging development of 'follow-on' versions, known as 'biosimilars'. Biological agents range from simple replacement hormones to complex monoclonal antibodies and soluble receptors: large, intricate proteins with unique tertiary and quaternary structures that are inherently difficult to replicate. Post-translational modifications, such as glycosylation, may occur from changes in cell lines and/or manufacturing processes, resulting in products that are highly similar, but not identical, to approved 'reference' agents, hence, the term 'biosimilar', rather than 'bioidentical'. Even minor modifications in manufacturing processes, which iteratively occur with reference products due to improvements in efficiency, scale up to meet commercial demands or changes in manufacturing sites, may alter biological function and/or immunogenicity, potentially changing their safety and efficacy profile. As biosimilars are now in randomised controlled trials for treatment of rheumatic diseases, rheumatologists face decisions regarding equipoise and will need to consider their clinical use versus reference products. A clear understanding of the inherent differences between reference antibodies and biosimilars, their clinical implications and the processes governing regulation, approval and clinical use of biosimilars, is paramount. A panel of international experts in the field of rheumatology recently convened to evaluate and discuss these issues.


Publication metadata

Author(s): Dorner T, Strand V, Castaneda-Hernandez G, Ferraccioli G, Isaacs JD, Kvien TK, Martin-Mola E, Mittendorf T, Smolen JS, Burmester GR

Publication type: Review

Publication status: Published

Journal: Annals of the Rheumatic Diseases

Year: 2013

Volume: 72

Issue: 3

Pages: 322-328

Print publication date: 19/12/2012

ISSN (print): 0003-4967

ISSN (electronic): 1468-2060

Publisher: BMJ PUBLISHING GROUP

URL: http://dx.doi.org/10.1136/annrheumdis-2012-202715

DOI: 10.1136/annrheumdis-2012-202715


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