New G-CSF agonists for neutropenia therapy

Jonathan Hoggatt, Louis M. Pelus

Research output: Contribution to journalReview article

16 Scopus citations

Abstract

Introduction: Granulocyte colony-stimulating factor (G-CSF; filgrastim) and its pegylated form (pegfilgrastim) are widely used to treat neutropenia associated with myelosuppressive chemotherapy and bone marrow transplantation, AIDS-associated or drug-induced neutropenia, and neutropenic diseases. G-CSF facilitates restoration of neutrophil counts, decreases incidence of infection/febrile neutropenia and reduces resource utilization. G-CSF is also widely used to mobilize peripheral blood stem cells for hematopoietic transplant. Areas covered: We review the therapeutic use, cost effectiveness and disease impact of G-CSF for neutropenia, development of G-CSF biosimilars and current next-generation discovery efforts. Expert opinion: G-CSF has impacted the treatment and survival of patients with congenital neutropenias. For chemotherapy-associated neutropenia, cost effectiveness and impact on survival are still unclear. G-CSFs are expensive and require systemic administration. Market entry of new biosimilars, some with enhanced half-life profiles, will probably reduce cost and increase cost effectiveness. There is no evidence that marketed or late development biosimilars display effectiveness superior to current G-CSFs. Second-generation compounds that mimic the activity of G-CSF at its receptor, induce endogenous ligand(s) or offer adjunct activity have been reported and represent attractive G-CSF alternatives, but are in preclinical stages. A significant therapeutic advance will require reduced depth and duration of neutropenia compared to current G-CSFs.

Original languageEnglish (US)
Pages (from-to)21-35
Number of pages15
JournalExpert Opinion on Investigational Drugs
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Filgrastim
  • G-CSF
  • G-CSF agonists
  • Neutropenia
  • Pegfilgrastim

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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