"Can't lie down smoothly", "The disease recurred once and reached the point of traveling in a wheelchair", "It feels petrified"... Recently, Li Yuchun introduced her new song "The Five Internals" in the second season of "My Bronze Age", which is a song she wrote from the first perspective of patients with ankylosing spondylitis. Ankylosing spondylitis is a chronic inflammatory disease mainly involved in the central axis joint.
As one of the treatment drugs for this disease, the original drug Xiumeile (adalimumab) has been known as the "king of medicine" for its high sales. Before Xiumei Le was included in the medical insurance, the patient's annual treatment cost was close to 200,000 yuan. After entering medical insurance in 2019, the annual drug treatment fee was reduced to about 30,000 yuan. With the successive launch of domestic adalimumab drugs, the burden on patients to take medication has been further reduced.
is high in young people
Li Yuchun recently admitted in the second season of "My Bronze Age" that he suffered from ankylosing spondylitis and felt "petified in the body" when it was severe. Ankylosing spondylitis is a general term for a group of chronic inflammatory diseases. It is characterized by involvement of the sacroiliac joint and spine, and can also involve peripheral joints or extra-articular tissues and organs.
20-40 years old is the main age group for patients with ankylosing spondylitis. Although the overall prevalence of ankylosing spondylitis is relatively low, about 0.3%, more than 3 million patients in my country are suffering from this disease. In addition to Li Yuchun, public reports include Jay Chou , Zhang Jiayi , Ada Choi , and other celebrities also suffer from ankylosing spondylitis. It is understood that the cause of ankylosing spondylitis is not yet clear, but it is currently believed to be related to multiple factors such as genetics, infection, environment, and immunity.
Chief physician of the Department of Rheumatology and Immunology at Peking University People's Hospital Zhang Xuewu said that the early symptoms of ankylosing spondylitis are not very typical, but there are still ways to distinguish the "characteristics" of pain. When the unknown cause is low back pain lasts for 3 months or more; the pain at night is worsened, and in severe cases, you may wake up in the middle of the night; when you wake up in the morning, your back is stiff (morning stiff), and exercise can relieve pain, so you need to be careful of ankylosing spondylitis.
Zhang Xuewu introduced that ankylosing spondylitis has a certain tendency to aggregate family, which is mainly related to the HLA-B27 gene. In order to detect lesions earlier, the main diagnostic basis for clinical diagnosis is basically based on nuclear magnetic resonance examination + gene examination + symptoms of lower back pain (including extraarticular symptoms).
cannot cure it early intervention
is not cured and has a high frequency of recurrence. Ankylosing spondylitis is also known as "undead cancer". At present, ankylosing spondylitis mainly controls symptoms and delays disease progression through drug treatment.
"There is no cure for ankylosing spondylitis and the current advocacy of the standard treatment." Zhang Xuewu said that the early treatment of ankylosing spondylitis is mainly non-steroidal anti-inflammatory drugs, and its main function is to prevent inflammation and relieve pain, but it cannot prevent the development of ankylosing spine. The emergence of biological agents controls the development of inflammation to a certain extent. The earliest biological agents that appeared were called tumor necrosis factor (TNF-α) antagonists. In recent years, a new class of interleukin-17A (IL-17A) inhibitors have emerged, which can not only control inflammation, relieve symptoms, but also inhibit the formation of pathological new bones, further preventing the continued deterioration of the disease.
Adalimumab is a commonly used TNF-α antagonist. Its original drug is Xiumeile, the famous "global medicine king" under AbbVie . Data shows that in the 20 years since its launch, Xiumei’s cumulative sales have reached US$191.5 billion, ranking first in the world in prescription drug sales for many years. In 2021, Xiumeira's sales were US$20.696 billion, breaking the US$20 billion mark for the first time.
In 2010, Xiumeile was approved for listing in China, and has been approved for rheumatoid arthritis, ankylosing spondylitis, plaque psoriasis, polyarticular juvenile idiopathic arthritis indications, etc. However, previously, according to Xiumeile's drug instructions, the patient's annual cost was nearly 200,000 yuan. In November 2019, Xiumei successfully entered the 2019 medical insurance negotiation catalog with a medical insurance payment standard of 1,290 yuan per bill. Calculated by the patient's subcutaneous injection every two weeks, the monthly cost is 2,580 yuan, and the annual treatment cost is reduced to about 30,000 yuan.
There are already many drugs in China
Biotel independently developed Gleli (adalimumab injection) has broken the import monopoly pattern. In November 2019, Gleli obtained the official approval of by the National Medical Products Administration for the treatment of autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis and psoriasis, becoming the first adalimumab biosimilar approved in China. Up to now, 6 adalimumab injections have been launched in my country, of which 5 are domestic drugs, and the accessibility of patients' medication has been further improved.
Xiumeile's previous annual treatment cost of 200,000 yuan was discouraged by many patients. According to the prospectus of Biotech, the original product Xiumeile has been sold for nearly ten years since it was launched in my country in 2010, while in 2018, less than 5,000 patients in my country used the drug. Most patients have limited payment ability, so they switch to using domestic fusion protein drugs such as Yisep, Amberno, and Jonker, and even give up treatment.
As the third adalimumab approved for marketing in my country, Su Lixin, a subsidiary of Innovent Biologics, is used to treat rheumatoid arthritis, ankylosing spondylitis and psoriasis. A Beijing Business Daily reporter learned from Innovent Biologics that Su Lixin is 1,088 yuan per dose and has a charitable drug gift project. Antonymosis patients are injected once every two weeks, 40mg once, and the annual treatment fee is 26,000 yuan.
In December 2020, Fuhong Hanlin Adalimumab (trade name: Handayuan) was approved for the treatment of rheumatoid arthritis, ankylosing spondylitis and psoriasis. According to the relevant person in charge of Fuhong Hanlin, Fuhong Hanlin's Handayuan price is 899 yuan per unit, with an annual treatment cost of about 23,400 yuan. Through the patient assistance project, the annual treatment cost is about 14,400 yuan.
In addition to the commonly used TNF-α antagonist adalimumab, three imported IL-17 (R) target monoclonal antibody injection drugs have been approved for marketing in China. Among them, the indications of Tskuchiyuzumab injection of Novartis have been included in medical insurance. According to incomplete statistics, there are still 10 anti-IL-17 monoclonal antibodies in China in the clinical trial stage, including Hengrui Medicine SHR-1314, Junshi Biologic JS005, Kangfang Biologic AK111, etc., all of which include the development of ankylosing spondylitis indications.
Beijing Business Daily reporter Yao Qian
