An introduction to biologics

An introduction to biologics 23.1 Introduction: Principles of biologics and their use as medicines 23.2 Protein biologics used as drugs 23.2.1 Proteins that function through enzymatic or regulatory activity. 23.2.1.1 Biologics as replacement of a deficient or abnormal protein. 23.2.1.2 Proteins that augment an existing biological process. 23.2.1.3 Proteins that provide a novel function or activity. 23.2.2. Proteins that function through specific targeting activity. 23.2.2.1. Monoclonal antibody nomenclature. 23.2.2.2. Naked monoclonal antibodies. 23.2.2.3. Conjugated monoclonal antibodies. 23.2.3. Recombinant protein vaccines.

Entry and competition in generic biologics

Patents for several blockbuster biological products are expected to expire soon. The Food and Drug Administration is examining whether biologies can and should be treated like pharmaceuticals with regard to generics. In contrast with pharmaceuticals, which are manufactured through chemical synthesis, biologies are manufactured through fermentation, a process that is more variable and costly. Regulators might require extensive clinical testing of generic biologies to demonstrate equivalence to the branded product. The focus of the debate on generic biologies has been on legal and health concerns, but there are important economic implications. We combine a theoretical model of generic biologies with regression estimates from generic pharmaceuticals to estimate market entry and prices in the generic biologic market. We find that generic biologies will have high fixed costs from clinical testing and from manufacturing, so there will be less entry than would be expected for generic pharmaceuticals. With fewer generic competitors, generic biologies will be relatively close in price to branded biologies. Policy makers should be prudent in estimating financial benefits of generic biologies for consumers and payers. We also examine possible government strategies to promote generic competition. Copyright © 2007 John Wiley & Sons, Ltd.

Biologics in rheumatoid arthritis - recommendations for Swiss practice.

The new paradigm of therapy in rheumatoid arthritis is to aim toward early and complete remission, using a larger use of conventional DMARDs and biologic agents. The present recommendations were established through a consensus to help practitioners in their daily use of those agents, to reflect the current "best practice" in Switzerland.

Entry strategies into biosimilars: assessment of entry modes into the field of biosimilars from the perspective of pharmaceuticals, generics and biologics companies

Indústria farmacêutica de hoje está em transição. Como grandes blockbuster drogas estão perdendo ou estão prestes a perder a proteção de patente, e as grandes empresas farmacêuticas não estão substituindo os produtos com novas drogas químicas inovadoras, a indústria busca novas áreas de crescimento. Uma dessas áreas é o mercado de biossimilares, que está sendo inseridos por produtos farmacêuticos, genéricos e empresas de produtos biológicos. Mesmo que o grande potencial de mercado será acordado por volta de 2020, quando importantes blockbusters biológicos perder a proteção de patente, as empresas precisam decidir logo se querem participar ou não devido a elevadas barreiras à entrada técnicos, bem como de desenvolvimento de longo prazos. Como todas as empresas vêm de diferentes origens, compreendem capacidades diferentes e têm diferentes incentivos de entrada, a questão que surge é se esses fatos estão relacionados com as suas estratégias de entrada correspondentes. A tese utiliza estudos de caso de cada segmento da indústria farmacêutica - produtos farmacêuticos, biológicos e genéricos - e examina através de entrevistas semi-estruturadas, por isso que os participantes do estudo de caso entrevistados explicitamente escolhido sua estratégia de entrada. Os dados de entrevistas será então ligada a quadros estratégicos da revisão da literatura e irá ser utilizado para uma comparação global e análise. O estudo revelou que o fundo do participante do mercado que influenciam a sua estratégia de entrada. Os principais pontos de influência derivam tanto as barreiras à entrada, bem como os incentivos de entrada. A tese não é possível determinar o sucesso futuro do modo de entrada analisados no novo mercado.

US Food and Drug Administration approval of generic versions of complex biologics: implications for the practicing physician using low molecular weight heparins

Low-molecular-weight heparins (LMWHs) have shown equivalent or superior efficacy and safety to unfractionated heparin as antithrombotic therapy for patients with acute coronary syndromes. Each approved LMWH is a pleotropic biological agent with a unique chemical, biochemical, biophysical and biological profile and displays different pharmacodynamic and pharmacokinetic profiles. As a result, LMWHs are neither equipotent in preclinical assays nor equivalent in terms of their clinical efficacy and safety. Previously, the US Food and Drug Administration (FDA) cautioned against using various LMWHs interchangeably, however recently, the FDA approved generic versions of LMWH that have not been tested in large clinical trials. This paper highlights the bio-chemical and pharmacological differences between the LMWH preparations that may result in different clinical outcomes, and also reviews the implications and challenges physicians face when generic versions of the original/innovator agents are approved for clinical use.

Do new biologics meet the unmet medical need in rheumatoid arthritis? Safety and efficacy of abatacept following B-cell depletion

Sir, anti TNF-α agents (aTNFs) are the most commonly prescribed biological agents in RA. More recently abatacept (ABA), a T-cell costimulation modulator, and rituximab (RTX), a monoclonal antibody directed against CD20, have become available. Observational studies suggest that switching to a new drug class may be more effective in uncontrolled RA than switching to a class of biologics to which the patient had unsuccessfully been exposed [1]. Information about the efficacy and safety of cycling strategies through third-line biologics is lacking. This study aimed to analyse the effectiveness and safety of switching patients to ABA as the third biological class after failure of aTNF plus RTX. The Swiss Clinical Quality Management (SCQM) programme for RA is a longitudinal population-based cohort, which has been approved by the local ethics committees of all participating centres [2]. For this analysis, we collected all the …

Biologics in rheumatoid arthritis--recommendations for Swiss practice

The new paradigm of therapy in rheumatoid arthritis is to aim toward early and complete remission, using a larger use of conventional DMARDs and biologic agents. The present recommendations were established through a consensus to help practitioners in their daily use of those agents, to reflect the current "best practice" in Switzerland.

Treatment with biologics of pregnant patients with rheumatic diseases

Due to limited human pregnancy experience safety issues in regard to children exposed antenatally to biological drugs are still under debate. A survey of new published experience on biological agents during pregnancy is necessary to assist clinicians with adequate counseling and management of patients who desire children.

Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis : Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Funded by: The Institute of Applied Health Sciences, University of Aberdeen The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis British Society for Rheumatology to the University of Manchester Schering-Plough Wyeth Laboratories Abbott Laboratories Amgen

Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis : Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Funded by: The Institute of Applied Health Sciences, University of Aberdeen The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis British Society for Rheumatology to the University of Manchester Schering-Plough Wyeth Laboratories Abbott Laboratories Amgen

Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis : Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Funded by: The Institute of Applied Health Sciences, University of Aberdeen The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis British Society for Rheumatology to the University of Manchester Schering-Plough Wyeth Laboratories Abbott Laboratories Amgen

Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

The aim of this study was to establish guidelines for the optimization of biologic therapies for health professionals involved in the management of patients with RA, AS and PsA. Recommendations were established via consensus by a panel of experts in rheumatology and hospital pharmacy, based on analysis of available scientific evidence obtained from four systematic reviews and on the clinical experience of panellists. The Delphi method was used to evaluate these recommendations, both between panellists and among a wider group of rheumatologists. Previous concepts concerning better management of RA, AS and PsA were reviewed and, more specifically, guidelines for the optimization of biologic therapies used to treat these diseases were formulated. Recommendations were made with the aim of establishing a plan for when and how to taper biologic treatment in patients with these diseases. The recommendations established herein aim not only to provide advice on how to improve the risk:benefit ratio and efficiency of such treatments, but also to reduce variability in daily clinical practice in the use of biologic therapies for rheumatic diseases