By contrast with small molecule drugs (aspirin, statins, antibiot

By contrast with small molecule drugs (aspirin, statins, antibiotics…) that can typically be described by a single chemical formula and duplicated relatively easily by chemical synthesis (also referred to as non-biological medicine), the development and manufacturing process of biologics are considerably more complex [13-15]. Biologics

are either derived or extracted from a living organism such as plasma-derived coagulation factors and heparins or produced through recombinant DNA methodology, which typically involves cloning and expression of the protein molecule into a carefully chosen host cell BMS-354825 in vivo line (i.e. yeast, mammalian, bacterial). This is followed by a specifically designed expansion, production, recovery, purification and packaging process; all of these conditions must be controlled if the efficacy

and safety of the final product are to be retained. Also integral to the function and safety of biologic drugs are different types of posttranslational modifications (e.g. glycosylation) [16]. Biologicals are used for the treatment of chronic and life-threatening diseases such as cancer, multiple sclerosis and rheumatoid arthritis. Treatment with biologicals is usually expensive and represents ever increasing pharmaceutical expenditures for the third-party payer. Recombinant full-length FVIII was first approved to be marketed in 1992–1993 with the international non-proprietary name ‘octocog alfa’ [10]. Since then other drugs based on recombinant Carfilzomib concentration FVIII have been developed and are currently available. They, however, differ with respect to the producing cell line (BHK, CHO), the genes expressed (full-length FVIII, B-domain deleted FVIII, VWF), the presence of proteins in

the culture medium (human plasma proteins, bovine serum albumin, check details aprotinin, none), the purification method (affinity chromatography using monoclonal antibodies or synthetic ligands), the stabilizing agent in the final formulation (human serum albumin, sucrose, mannitol), the viral inactivation steps (treatment with solvent-detergent, pasteurization, nanofiltration. Because of these many differences in the manufacturing of blood clotting factors, all currently available products are not the same and should be considered as specific and unique entities. These differences will be greater in the future considering the multiple strategies of extending half-life that are currently being applied to FVIII (pegylation, Fc-fusion, single-chain molecule) [17]. The term ‘biosimilar’ (also referred to as ‘follow-on biologic’ (FOB), ‘subsequent entry biologics’ or ‘generic biologic’) refers to a biological product developed to be highly similar as opposed to identical to an existing licensed biological product.

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