The number of antibody-based biosimilar therapeutics approved in the European Union or United States is poised to grow substantially in 2016 and 2017. The originator products that target tumor necrosis factor (TNF) have been of particular interest to the biosimilar industry due to the expiration of key patents and the large global markets for the products. In 2013, the three top-selling originator anti-TNF products were infliximab (Remicade®), etanercept (Enbrel®) and adalimumab (Humira®), which combined had global sales of nearly $18 billion that year. The first biosimilar anti-TNF products approved in either the EU or US were Inflectra® and Remsima®, both of which are versions of infliximab. Inflectra® and Remsima® were approved in the EU in September 2013 for rheumatoid arthritis, Crohn’s disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, and psoriasis.
While no antibody-based biosimilar products were approved in either the EU or US in 2014 or 2015, two products have been approved in each of these regions so far in 2016, and more may be approved soon. In the EU, the biosimilar etanercept BENEPALI® was approved in January 2016 for moderate to severe rheumatoid arthritis, psoriatic arthritis, severe ankylosing spondylitis, severe non-radiographic axial spondyloarthritis, and plaque psoriasis, and the biosimilar infliximab Flixabi® was approved in May 2016 for rheumatoid arthritis, Crohn’s disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, and psoriasis. In the US, Inflectra® was approved in April 2016 for the treatment of moderately to moderately to severely active rheumatoid arthritis, severely active Crohn’s disease, moderately to severely active ulcerative colitis, active ankylosing spondylitis, active psoriatic arthritis, chronic severe plaque psoriasis, and the biosimilar etanercept Erelzi® was approved in August 2016 for moderate to severe rheumatoid arthritis, moderate to severe polyarticular juvenile idiopathic arthritis, active psoriatic arthritis, active ankylosing spondylitis, and chronic moderate to severe plaque psoriasis. A biosimilar adalimumab (ABP-501) may be approved soon, as the Food and Drug Administration’s (FDA) Arthritis Advisory Committee voted unanimously to support approval of it in July 2016. The product was recommended for the treatment of rheumatoid arthritis, juvenile idiopathic arthritis in patients aged 4 years and older, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, adult ulcerative colitis, and plaque psoriasis.
Although the FDA does not release comprehensive lists of products in review, the European Medicines Agency (EMA) does provide limited information on applications for centralized marketing authorization under evaluation. As of August 3, 2016, a total of 6 applications for biosimilar adalimumab (3 applications), etanercept (1 application), and the anti-CD20 rituximab (2 applications) were under evaluation. In late August, EMA also accepted for review a marketing authorization application for a proposed biosimilar trastuzumab, which is used to treat certain HER2-positive breast and gastric cancers. Thus, there may soon be as many as 11 biosimilar antibody-based therapeutics on the market in the EU, and many of these could also gain approval in the US.