概括
在欧盟和美国批准的生物类似胰岛素是安全有效的,尽管与原始产品的制造差异. 监管途径确保没有临床相关的区别,允许患者和处方者自信地使用.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 生物技术是生物技术.
背景情况:
- 自2014年以来,生物类似胰岛素已可用,在欧盟和美国批准了多种产品.
- 与参考胰岛素相比,有限的商业成功可能源于医生和患者对疗效,安全性和质量的担忧.
- 与仿制药不同,生物仿制药可能有轻微的制造相关差异,需要严格的监管评估.
研究的目的:
- 审查支持生物类似胰岛素在欧盟和美国获得批准的关键临床研究.
- 讨论生物类似胰岛素批准的监管要求和科学基础.
- 为了解决有关生物类似胰岛素可互换性和免疫性方面的担忧.
主要方法:
- 关键的第1期euglycaemic葡萄糖研究的综述,评估药理动力学和药理动力学概况.
- 对证明安全性和有效性的支持性第三期临床试验的分析.
- 检查临床前研究,包括激素受体结合和基于细胞的测定.
主要成果:
- 欧盟和美国的监管批准途径确保生物类似胰岛素与参考产品可比.
- 关键研究证实,在疗效,安全性或质量方面没有临床相关的差异.
- 目前的数据支持未经批准的生物类似胰岛素的使用.
结论:
- 严格的监管框架保证了批准的生物类似胰岛素与它们的参考产品相当.
- 医生和糖尿病患者可以自信地开处方并使用欧盟/美国批准的生物类似胰岛素.
- 目前正在进行的可互换性和免疫性评估进一步支持将生物类似胰岛素纳入临床实践.
相关概念视频
Insulin Formulations: Types and Delivery
150
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
150
Insulin: Biosynthesis, Chemistry, and Preparation
332
The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
332
Insulin: Dosing Regimen and Adverse Effects
135
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
135
Drug Regulation
1.3K
Drug regulation encompasses the management of drug usage by evaluating its safety and efficacy through assessments conducted by regulatory authorities. Regrettably, the history of drug regulation is marred by several catastrophic events. One such incident is the Elixir Sulfanilamide tragedy, in which the toxic compound diethyl glycol was included in a sweet-tasting medication, leading to numerous fatalities. This event prompted the enactment of the Food, Drug, and Cosmetic Act in 1938. Under...
1.3K
Insulin: The Receptor and Signaling Pathways
1.1K
Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
1.1K
Bioequivalence: Overview
905
Pharmaceutical equivalents, by definition, are drug products with the same active ingredient in the same quantities, encapsulated in identical dosage forms, and intended for the same administration routes. These pharmaceutical equivalents are deemed bioequivalent if the bioavailability of the active entity in the drug preparations is similar. Moreover, pharmaceutical equivalents demonstrating bioequivalence are also regarded as therapeutically equivalent. This means that when used as directed,...
905


