BACKGROUND The Biologics Price Competition and Innovation Act, introduced as part of the Affordable Care Act, directed the FDA to create an approval pathway for biologic products shown to be biosimilar or interchangeable with an FDA-approved innovator drug. These biosimilars will not be chemically identical to the reference agent. Investigational studies conducted with biosimilar agents will li...

Biosimilars are biological medicinal products that contain a version of the active substance of an already authorised original biological medicinal product (the innovator or reference product). The first approved biosimilar medicines were small proteins, and more recently biosimilar versions of innovator monoclonal antibody (mAb) drugs have entered development as patents on these more complex p...

Background For the development of biosimilar monoclonal antibodies (mAb) or related substances containing the IgG Fc part it is mandatory to fully compare immunological properties between originator and biosimilar in a “comparability exercise” [1]. The most complex Fc associated function to mediate antibody dependent cellular cytotoxicity (ADCC) needs to be characterized using the active substa...

To make informed decisions about the safety, efficacy, and clinical utility of a biosimilar, health care providers should understand the types and be able to analyze data generated from a biosimilar development program. This article reviews the biosimilar guidelines, the biosimilar development process to provide education and context about biosimilarity, and uses examples from infliximab biosim...

Background For the development of biosimilar monoclonal antibodies or related substances containing the IgG Fc part it is mandatory to fully compare immunological properties between originator and biosimilar in a “comparability exercise” [1]. The important Fc associated functions to mediate antibody dependent cellular cytotoxicity (ADCC) and complement dependent cytotoxicity (CDC) need to be ch...

Since biosimilars generally have undergone less clinical research than originators, their place in therapy can be strengthened by increasing the amount of clinical evidence supporting their approval. This report describes an approach in which a "total evidence" network meta-analysis is performed that compares the biosimilar not only with the originator but also with the previous standard of car...

Last month, Part 1 of this discussion brief ly described the regulatory landscape for developing biosimilar therapeutic monoclonal antibodies (TMAbs). We identified certain specific structural components of TMAb drug substances that warrant particular attention because alterations to them are likely to affect therapeutic safety and effectiveness. Now we conclude by considering whether studies o...

Biosimilars represent a new trend in the treatment of many immune-mediated inflammatory diseases. Regulatory requirements for approval of biosimilars are different from those of originators and rely mostly on the evidence generated from bioequivalence studies and in particular from RCTs. Our goal in this review was to search for relevant studies from randomized controlled trials on the biosimil...

Given that a new wave of biosimilar insulins will likely enter the market in coming years, it is important to understand patient perspectives on these biosimilars. A survey (N = 3214) conducted by the market research company dQ&A, which maintains a 10 000-patient panel of people with type 1 or type 2 diabetes in roughly equal measure, investigated these perspectives. The survey asked whether pa...

Biosimilars are approved biologics with comparable quality, safety, and efficacy to a reference product. Unlike generics, which are chemically manufactured copies of small-molecule drugs with relatively simple chemical structures, the biosimilar designation is applied to drugs that are produced by living organisms, implying much more difficult to control manufacturing and purification procedure...