Bayesian methods for analysis of biosimilar phase III trials.

A biologic is a product made from living organisms. A biosimilar is a new version of an already approved branded biologic. Regulatory guidelines recommend a totality-of-the-evidence approach with stepwise development for a new biosimilar. Initial steps for biosimilar development are (a) analytical comparisons to establish similarity in structure and function followed by (b) potential animal studies and a human pharmacokinetics/pharmacodynamics equivalence study. The last step is a phase III clinical trial to confirm similar efficacy, safety, and immunogenicity between the biosimilar and the biologic. A high degree of analytical and pharmacokinetics/pharmacodynamics similarity could provide justification for an eased statistical threshold in the phase III trial, which could then further facilitate an overall abbreviated approval process for biosimilars. Bayesian methods can help in the analysis of clinical trials, by adding proper prior information into the analysis, thereby potentially decreasing required sample size. We develop proper prior information for the analysis of a phase III trial for showing that a proposed biosimilar is similar to a reference biologic. For the reference product, we use a meta-analysis of published results to set a prior for the probability of efficacy, and we propose priors for the proposed biosimilar informed by the strength of the evidence generated in the earlier steps of the approval process. A simulation study shows that with few exceptions, the Bayesian relative risk analysis provides greater power, shorter 90% credible intervals with more than 90% frequentist coverage, and better root mean squared error.