Información de la revista
Vol. 34. Núm. S1.
Consenso sobre el uso de factores estimuladores de colonias de granulocitos biosimilares para la corrección de la neutropenia asociada en pacientes con cáncer
Páginas 29-44 (Marzo 2010)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 34. Núm. S1.
Consenso sobre el uso de factores estimuladores de colonias de granulocitos biosimilares para la corrección de la neutropenia asociada en pacientes con cáncer
Páginas 29-44 (Marzo 2010)
Acceso a texto completo
Medicamentos biosimilares. Controversias científicas y legales
Biosimilar medicines. Scientific and legal disputes
Visitas
10960
B. Dorantes Calderón
Autor para correspondencia
, I.M. Montes Escalante
Unidad de Gestión Clínica de Farmacia Hospitalaria, Hospital de Valme, Sevilla, España
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen

La caducidad de las patentes de los primeros medicamentos biotecnológicos comercializados está dando origen a la aparición en el mercado de los medicamentos biosimilares. Éstos se definen, según la EMEA, como fármacos de origen biotecnológico que han demostrado ser comparables al medicamento de referencia, una vez que su patente ha expirado. Las modificaciones en el proceso de fabricación de medicamentos biotecnológicos o el cambio de tratamiento de una molécula biotecnológica a otra no ha sido tema de debate hasta la aparición en el mercado de estos medicamentos biosimilares. Es entonces cuando se ha polemizado, entre otras cuestiones, sobre los posibles riesgos de su intercambio con la molécula de referencia. Las guías publicadas por la EMEA, para la autorización de fármacos biosimilares, aseguran que éstos sean tan eficaces y seguros como cualquier otro fármaco nuevo de biotecnología que se comercializa o como cualquier otro que, estando comercializado, cambia su proceso de fabricación. Su entrada en el mercado promoverá la competencia y conseguirá disminuir el alto impacto económico que soportan los sistemas sanitarios, tras la incorporación de nuevas terapias basadas en el uso de medicamentos de biotecnología.

Palabras clave:
Biotecnología
Biosimilares
Follow-on proteins
Switching
Intercambio terapéutico
Abstract

Patent expiry dates for early biotechnological drugs is giving rise to the availability of biosimilar drugs. According to the EMEA, these are defined as drugs with a biotechnological origin that have proven comparable to their reference product once the latter's patent expired. Modifications in the manufacturing process of biotechnological medications or treatment changes from one biotechnological molecule to another have not been debated until these biosimilar drugs have become available. It is then that, among other issues, the potential risks of their substitution for reference molecules became controversial. EMEA guidelines for biosimilar drug approval grant that these will be as effective and safe as any other newly available biotechnological medicinal product, or as any other drug undergoing changes in its manufacturing processes once marketed. Their availability will promote competition and reduce the high financial impact healthcare systems endure following the introduction of new therapies based on biotechnological drugs.

Key words:
Biotechnology
Biosimilar
Follow-on proteins
Switching
Therapeutic exchange
El Texto completo está disponible en PDF
Bibliografía
[1.]
Real Decreto 1345/2007, de 11 de octubre, por el que se regula el procedimiento de autorización, registro y condiciones de dispensación de los medicamentos de uso humano fabricados industrialmente. Jefatura del Estado. BOE n.° 275 de 7 de noviembre de 2007.
[2.]
Convention on Biological Diversity. United Nations. Cartagena Protocol on Biosafety. Frequently Asked Questions on the Biosafety Protocol [consultado 11/2009]. Disponible en: http://www.cbd.int/biosafety/bchfaqs2.pdf
[3.]
P.E. Johnson.
Implications of biosimilars for the future.
Am J Health-Syst Pharm, 65 (2008), pp. S16-S22
[4.]
Committee for Medical Products for Human Use Questions and answers on biosimilar medicines (similar biological medicinal products) EMEA/74562/2006 Rev. 1. Londres, Octubre 2008.
[5.]
A. Martínez Mogarra.
Introducción a la biotecnología y generalidades sobre cultivos celulares.
Biotecnología aplicada a la medicina, pp. 141-154
[6.]
Coutouly G, Frings J, Grainger J, Corda Mannino A, Serafimov O, Ucelly S, et al. Biotechnology: past and present, European Initiative for Biotechnology Education [consultado 11/2009]. Disponible en: http://www.eibe.info/
[7.]
The Pharmaceutical Century. Ten decades of drug discovery. ACS Publications [consultado 11/2009]. Disponible en: http://journals.iranscience.net: 800/default/pubs.acs.org/journals/pharmcent/Ch1.html
[8.]
P. Brown, J.P. Brandel, M. Preese, T. Sato.
Iatrogenic Creutzfeldt-Jakob disease. The warning of an era.
[9.]
Lieff Cabraser Heimann & Bernstein, LLP. Abogados. Litigio de Hemofilia.com [consultado 11/2009]. Disponible en: http://www.litigiodehemofilia.com/
[10.]
C. Vendrely, T. Scheibel.
Biotechnological production of spidersilk proteins enables new applications.
Macromol Biosci, 7 (2007), pp. 401-409
[11.]
M. Nowicki.
Basic facts about biosimilars.
Kidney Blood Press Res, 30 (2007), pp. 267-272
[12.]
J. Bueren, J.L. Montellón.
Curso de Biotecnología Aplicada [consultado 11/2009].
7.a ed., Sanidad y Ediciones SL, (2007),
[13.]
Gene Patents and Global Competition Issues Protection of Biotechnology under Patent Law. Genetic Engineering & Biotechnology News 2006;26 [consultado 11/2009]. Disponible en: http://www.genengnews.com/articles/chitem.aspx?aid = 1163
[14.]
Remarks of Congressman Henry A. Waxman. Biosimilars 2007 Conference September 24, 2007 [consultado 11/2009]. Disponible en: http://www.biosimilarstoday.com/Waxman.pdf
[15.]
D.M. Dudzinski, A.S. Kesselheim.
Scientific and legal viability of follow-on protein drugs.
N Engl Jmed, 358 (2008), pp. 843-849
[16.]
Engel & Novitt, LLP. Potential savings that might be realized by the medicare program from enactment of legislation Such as the access to life-saving medicine Act (H.R. 6257/S. 4016) that establishes a new cBLA pathway for follow-on biologics. A report to pharmaceutical care management association (PCMA) based upon a preliminary assessment of available data 2; 2007 [consultado 11/2009]. Disponible en: http://pcmanet.org/assets/2008-03-25_Research_EN %20Paper %20on %20Follow-on %20Biologics %20Jan. %202007.pdf
[17.]
T. Maeder.
Reacción ante los medicamentos huérfanos.
Investigación y Ciencia, 322 (2003), pp. 77-83
[18.]
M. Nowicki.
Basic facts about biosimilars.
Kidney Blood Press Res, 30 (2007), pp. 267-272
[20.]
Biotechnology Medicines in Development, Report 2006 [consultado 11/2009]. Disponible en: http://www.allhealth.org/BriefingMaterials/hRMA418BiotechMeds-415.pdf
[21.]
Biotechnology Medicines in Development, Report 2008 [consultado 11/2009]. Disponible en: http://www.phrma.org/files/Biotech %202008.pdf
[22.]
R.G. Wenzel.
Biosimilars: illustration of scientific issues in two examples.
Am J Health-Syst Pharm, 65 (2008), pp. S9-S15
[23.]
Estrategia farmacéutica de la OMS. Ampliación del acceso a los medicamentos esenciales. Informe de la secretaría. 55a. Asamblea Mundial de la Salud. 28 de marzo de 2002 [consultado 11/2009]. Disponible en: http://www.femeba.org.ar/fundacion/quienessomos/Novedades/estrategiafarmaceuticaoms.pdf
[24.]
P.E. Johnson.
Implications of biosimilars for the future.
Am J Health-Syst Pharm, 65 (2008), pp. S16-S22
[25.]
A. Domínguez-Gil.
Los biosimilares llegan a Europa.
Rev Esp Econ Salud, 6 (2007), pp. 82-86
[26.]
L. Zuñiga, B. Calvo.
Regulatory aspects of biosimilars in Europe.
Trends in Biotechnology, 27 (2009), pp. 385-387
[27.]
The European Parliament and the Council of the European Union. Directives 2004/27/EC of the European Parliament and of the Council of 31March 2004 amending Directive 2001/83/EC on the Community code relating to medicinal products for human use. Official J European Union 2004. p. 34-57.
[28.]
EMEA/CHMP/437/04. Guideline on similar biological medicinal products. (CHMP adopted Sep 2005).
[29.]
EMEA/CHMP/49348/05. Guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: quality issues (CHMP adopted Feb 2006).
[30.]
EMEA/CHMP/BMWP/42832/05. Guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: Non-clinical and clinical issues (CHMP adopted Feb 2006).
[31.]
EMEA/CHMP/BMWP/14327/06. Guideline on inmunogenicity assesment of biotechnology-derived therapeutic proteins (CHMP adopted Jan 2007).
[32.]
EMEA/CHMP/BMWP/101695/06. Guideline on comparability of biotechnology-derived medicinal products after a change in the manofacturing process: non clinical and clinical issues (CHMP adopted Jul 2008).
[33.]
EMEA/CHMP/32775/05. Annex guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: non-clinical and clinical issues. Guidance on similar medicinal products containing recombinant human insulin (CHMP adopted Feb 2006).
[34.]
EMEA/CHMP/94528/05. Annex guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: non-clinical and clinical issues. Guidance on similar medicinal products containing somatropin (CHMP adopted Feb 2006).
[35.]
EMEA/CHMP/BMWP/301636/08. Similar medicinal products containing recombinant Erythropoietins. (Release for consultation Jan 2010).
[36.]
EMEA/CHMP/BMWP/31329/05. Annex to guideline on similar biological medicinal products containing biotechnology-derived proteins as active substance: non-clinical and clinical issues. Guidance on similar medicinal products containing recombinant Granulocyte-colony stimulating factor (CHMP adopted Feb 2006).
[37.]
EMEA/CHMP/BMWP/118264/07. Guideline on similar biological medicinal products containing low-molecular-weight-heparins (CHMP adopted Oct 2008).
[38.]
EMEA/CHMP/BMWP/114720/09. Immunogenicity assessment of monoclonal antibodies intended for in vivo clinical use. (Deadline for comments Jun 2009).
[39.]
Biosimilars debate heats up at BIO. Managing IP magazine. Jun 2008. Available at: http://www.managingip.com/Article/1958965/Biosimilar-debate-heats-up-at-BIO.html.f [Acceso: noviembre 2009].
[40.]
S. Porter.
Human immune response to recombinant human proteins.
J Pharm Sci, 90 (2001), pp. 1-11
[41.]
Biotech medicines: first biosimilar drug on EU market. Press releases Rapid. IP/06/511. Brussels, 20 April 2006 [consultado 11/2009]. Disponible en: http://europa.eu/rapid/pressReleasesAction.do?reference=IP/06/511&format=HTML&aged=0⟨uage=EN&guiLanguage=en
[42.]
M. Kessler, D. Goldsmisth, H. Schellekens.
Immunogenicity of biopharmaceuticals.
Nephrol Dial Transplant, 21 (2006), pp. v9-v12
[43.]
E. Koren, L.A. Zuckerman, A.R. Mire-Sluis.
Immune responses to therapeutic proteins in humans-clinical significance, assessment and prediction.
Curr Pharm Biotechol, 3 (2002), pp. 349-360
[44.]
H. Schellekens.
When biotech proteins go off-patent.
Nature Biotech, 22 (2004), pp. 1357-1359
[45.]
B.A. Cohen, J. Oger, A. Gagnon, G. Giovannoni.
The implications of immunogenicity for protein-based multiple sclerosis therapies.
J Neurol Sci, 275 (2008), pp. 7-17
[46.]
M. Wadwa.
Unwanted immunogenicity: Implications for follow-on biologicals.
Drug Information Journal, 41 (2007), pp. 1-10
[47.]
P.G. Swann, M. Tolnay, S. Muthukkumar, M.A. Shapiro, B.L. Rellahan, K.A. Clouse, et al.
lnsiderations for the development of therapeutic monoclonal antibodies.
Curr Opin Immunol, 20 (2008), pp. 493-499
[48.]
Roberts B. Should the FDA create an expedited approval process for generic biologic drugs? A report to the science, technology and economic policy board of the national research council. 2007;April 11.
[49.]
S. Gottlieb.
Biosimilars: Policy, clinical and regulatory considerations.
Am J Health-Syst Pharm, 65 (2008), pp. S2-S8
[50.]
U. S. Department of Health and Human Services. Testimony. Statement by Janet Woodcock, MD. Deputy Commissioner for Operations Food and Drug Administration. DHHS on Follow-on Protein Products before the Committee on Oversight and Government Reform United States House of Representatives. March 26, 2007 [consultado 11/2009]. Disponible en: http://www.hhs.gov/asl/testify/2007/04/t20070326a.html
[51.]
A.B. Engelberg, A.S. Kesselheim, J. Avorn.
Balancing innovation, access, and profits - market exclusivity for biologics.
N Engl J Med, 361 (2009), pp. 1917-1919
[52.]
U. S. Department of Health and Human Services. Testimony. Statement by Janet Woodcock, MD. Deputy Commissioner for Operations Food and Drug Administration. DHHS on Follow-on Protein Products before the Committee on Oversight and Government Reform United States House of Representatives. March 26, 2007 [consultado 11/2009]. Disponible en: http://www.fda.gov/NewsEvents/Testimony/ucm154017.htm
[53.]
Orden de 28 de mayo de 1986 por la que se establecen los medicamentos prescritos que no pueden ser sustituidos por otros en la dispensación. Ministerio de Sanidad y Consumo. BOE n.° 135, 6 de junio de 1986. p. 20443.
[54.]
Orden SCO/2874/2007, de 28 de septiembre, por la que se establecen los medicamentos que constituyen excepción a la posible sustitución por el farmacéutico con arreglo al artículo 86.4 de la Ley 29/2006, de 26 de julio, de garantías y uso racional de los medicamentos y productos sanitarios. BOE n.° 239 de 5 de octubre 2007.
[55.]
Ley 29/2006, de 26 de julio, de garantías y uso racional de los medicamentos y productos sanitarios. Jefatura del Estado. BOE n.° 178 de 27 de julio de 2006. p. 28122-65.
[56.]
Orden de 13 de mayo de 1985, sobre medicamentos sometidos a especial control médico en su prescripción y utilización BOE n.° 121 de 21 de mayo de 1985.
[57.]
S.A. Chen, A.E. Izu, J. Mordenti, A. Rescigno.
Bioequivalence of two recombinant human growth hormones in healthy male volunteers after subcutaneous administration.
Am J Ther, 2 (1995), pp. 190-195
[58.]
C. Rougeot, P. Marchand, F. Dray, F. Girard, J.C. Job, M. Pierson, C. Ponte, P. Rochiccioli, R. Rappaport.
Comparative study of biosynthetic human growth hormone immunogenicity in growth hormone deficient children.
Hormone research, 35 (1991), pp. 76-81
[59.]
P. Pirazzoli, E. Cacciari, M. Mandini, A. Cicognani, S. Zucchini, T. Sganga, et al.
Follow-up of antibodies to growth hormone in 210 growth hormone-deficient children treated with different commercial preparations.
Acta Pediatrica, 84 (1995), pp. 1233-1236
[60.]
J.C. Mani, J.M. Bras, C. Agut, B. Pau, N. Vita, P. Ferrara, et al.
Accurate topological comparison of two recombinant human growth hormones by optical surface plasmon resonance.
Analytical Bio-chemistry, 248 (1997), pp. 50-62
[61.]
H. Ledford.
Biotech go generics: the same but different.
Nature, 449 (2007), pp. 274-276
[62.]
Resolución de 29 de marzo de 1989, de la Secretaría General de Asistencia Sanitaria, por la que se crea el Comité Asesor de la hormona de crecimiento y sustancias relacionadas. BOE n.° 120 de 20 de mayo de 1989.
[63.]
Resolución de 16 de julio de 1992, del Servicio Andaluz de Salud, por la que se crea el SIRHOCO (Sistema de información centralizado de información y registro mecanizado de patología del crecimiento susceptible de tratamiento con hormona de crecimiento) y Comité Asesor del Organismo.
[64.]
Agencia Española del Medicamento y Productos Sanitarios. Comunicación sobre riesgos de medicamentos para profesionales sanitarios. Ref. 2005/08. Nota informativa: “Riesgos del uso de hormona de crecimiento en personas sanas y paso a uso hospitalario”. 22 de abril de 2005.
[65.]
E. Fineberg, T. Kawabata, D. Finco-Kent, et al.
Immunological responses to exogenous insulin.
Endocrine reviews, 28 (2007), pp. 625-652
[66.]
M. Flendrie, M.C. Creemers, P.M. Welsing, A.A. Den Broeder, P.L. van Riel.
Survival during treatment necrosis factor blocking agent in rheumatoid arthritis.
Ann Rheum Dis, 62 (2003), pp. ii30-ii33
[67.]
K. Laas, R. Peltomaa, H. Kautiainen, M. Leirisalo-Repo.
Clinical impact of switching from infliximab to etanercept in patiens with rheumatoid arthritis.
Clin Rheumatol, 27 (2008), pp. 927-932
[68.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusion. Remicade [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/remicade/remicade.htm
[69.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusion. Humira [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/humira/humira.htm
[70.]
M.C. Wick, S. Ernestam, S. Lindblad, J. Bratt, L. Klareskog, R.F. van Vollenhoven.
Adalimumab (Humira) restores clinical response in patients with secondary loss of efficacy from infl iximab (Remicade) or etanercept (Enbrel): results from the STURE registry at Karolinska University Hospital.
Scand J Rheumatol, 34 (2005), pp. 353-358
[71.]
A.N. Bennett, P. Peterson, A. Zain, J. Grumley, G. Panayi, B. Kirkham.
Adalimumab in clinical practice. Outcome in 70 rheumatoid arthritis patients, including comparison of patients with and without previous anti-TNF exposure.
Rheumatology (Oxford), 44 (2005), pp. 1026-1031
[72.]
S.N. Nikas, P.V. Voulgari, Y. Alamanos, C.G. Papadopoulos, A.I. Venetsanopoulu, A.N. Georgiadis, et al.
Efficacy and safety of switching from infl iximab to adalimumab: a comparative controlled study.
Ann Rheum Dis, 65 (2006), pp. 257-260
[73.]
M.D. Bennett, S. Luminari, A.R. Nissenson, et al.
Pure red-cell aplasia and epoetin therapy.
N Engl JMed, 351 (2004), pp. 1403-1408
[74.]
A.M. Evens, C.L. Bennett, S. Luminari.
Epoetin-induced pure redcell aplasia (PRCA): preliminary results from the research on adverse drug events and reports (RADAR) group.
Best Practice and Research Clinical Haematology, 18 (2005), pp. 481-484
[75.]
J. Carracedo, J.A. Madueño, R. Ramírez, A. Martín-Malo, A.L. de Francisco, P. Aljama.
Antibody-mediated pure red-cell aplasia (PCRA): the Spanish experience.
J Nephrol, 18 (2005), pp. 382-387
[76.]
Ficha técnica del producto EPREX revisada en junio de 2008. Titular de la autorización de la comercialización: Janssen-Cilag [consultado 11/2009]. Disponible en: https://sinaem4.agemed.es/consaem/especialidad.do?metodo=verFichaWordPdf&codigo=60579&formato=pdf&formulario=FICHAS
[77.]
J. Assunçao, J. Vinhas.
Antibody-mediated pure red cell aplasia (PCRA) on switching from darbopoetin alfa to epoetin beta: what are the implications?.
NDT Plus, 1 (2008), pp. 230-232
[78.]
F.R. Rosendaal, H.K. Nieuwenhuis, H.M. van der Berg.
A sudden increase in factor VIII inhibitor development in multitransfused hemophilia patiens in The Netherlands: Dutch Hemophilia Study Group.
Blood, 81 (1993), pp. 2180-2186
[79.]
Catálogo Especialidades Farmacéuticas Madrid: Consejo General de Colegios Oficiales de Farmacéuticos; 2008.
[80.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusion. Kogenate [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/kogenatebayer/kogenatebayer.htm
[81.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusion. Helixate [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/helixatenexgen/helixatenexgen.htm
[82.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusion. Advate [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/advate/advate.htm
[83.]
EMEA. European Public Assessment Report (EPAR). Scientific Discusión. ReFacto [consultado 11/2009]. Disponible en: http://www.emea.europa.eu/humandocs/Humans/EPAR/refacto/refacto.htm
[84.]
I. Scharrer, H.J. Ehrlich.
Lack of evidence for increased inhibitor incidence in patients switched from plasma-derived to recombinant factor VIII, 7 (2001), pp. 346-348
[85.]
A.R. Giles, G.E. Rivard, J. Teitel, I. Walker.
Surveillance for factor VIII Inhibitor Development in the Canadian Hemophilia A Population Following the Widespread Introduction of Recombinant Factor VIII Replacement Therapy.
Transfus Sci, 19 (1998), pp. 139-148
[86.]
E. Singelton, J. Smith, M. Kavanagh, B. White, B. Nolan, et al.
Survey of factor VIII inhibitor development in the Irish haemophilia A population following the switch from CHO-producted rFVIII to BHK-produced rFVIII-FS.
Haemophilia, 12 (2006), pp. 14
[87.]
T. Abshire, S.C. Gouw, J.G. van der Bom, et al.
Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: the CANAL cohort study.
Blood, 109 (2007), pp. 4693-4697
[88.]
Guía Farmacoterapéutica de Hospital 2002. Sistema Sanitario Público de Andalucía. Actualización diciembre 2008. Disponible en: http://www.juntadeandalucia.es/servicioandaluzdesalud/library/plantillas/externa.asp?pag=.../../publicaciones/datos/102/html/Home.htm
Copyright © 2010. Sociedad Española de Farmacia Hospitalaria
Idiomas
Farmacia Hospitalaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.