Sorting Through the Confusion of Biologic Drug Names

In This Article

The 'Mibs'

The suffix "zomib" is the designation for protease or proteasome inhibitors. Mibs are small molecules that work inside cancer cells to slow proliferation and increase apoptosis (cell death).

In 2015, the FDA approved ixazomib (Ninlaro®; Takeda Oncology) for multiple myeloma. Others mibs approved for use in the United States include bortezomib and carfilzomib.^[7]

The 'Nibs'

The suffix "nib" indicates a small-molecule inhibitor ("nib" is verbal shorthand for "inhibit") of kinase enzymes. More specifically, "tinib" is used for tyrosine kinase inhibitors, "anib" for angiogenesis inhibitors, and rafenib for rapidly accelerated fibrosarcoma (RAF) kinase inhibitors.^[8]

The FDA approved four nibs in 2015: alectinib (Alecensa®; Genentech) for advanced non-small cell lung cancer, cobimetinib (Cotellic®; Genentech) for advanced melanoma, lenvatinib (Lenvima®; Eisai Inc.) for advanced thyroid cancer, and osimertinib (Tagrisso™; AstraZeneca) for non-small cell lung cancer.^[3]

Some General Rules to Remember

In attempting to understand the characteristics of biologics and related drugs (Table 4), it can be useful to remember some general rules. Biologic and related drugs are most commonly used in oncology and immune system disorders or diseases. Often, the drug name gives information about the pharmacology and pharmacokinetics. For example, all mabs are proteins, which must be administered parenterally. Nibs are substrates of cytochrome P450 enzymes and therefore liable to drug interactions.^[9] Chances of allergic reactions are greater with mabs, especially in drugs that are not fully human. Adverse effects are related to the system targeted (eg, epidermal growth factor receptor antagonists would be likely to cause rash and diarrhea).

Table 4. Characteristics of Biologics and Related Drugs^[4,9,10]

Characteristic	Mabs	Mibs, Nibs
Size and structure	Larger complex molecules with structure affected by manufacturing process	Single molecule with exact chemical structure
Chemical class	Protein/peptide	Often inorganic
Production	Cell culture	Chemical synthesis
Generic	Biosimilar	Identical copy
Site of action	Cell membrane receptors	Intracellular
Specificity	Specific	Usually nonspecific
Stability	Sensitive to external conditions (eg, heat, microbial contamination)	Generally stable
Route of administration	Subcutaneous or intravenous	Various, including oral
Half-life	Longer	Shorter
Immunogenicity	Greater immunogenic potential	Usually nonimmunogenic
Drug interactions	Less common	More common

mab = monoclonal antibody

Dissecting the names of biologics and related drugs helps in the pronunciation and prediction of their properties.

Consider that the seven syllables of hy-dro-chlor-o-thi-a-zide easily roll off the tongue of most clinicians. The pronunciation of mabs, mibs, and nibs can be similarly fluent with a look at the drug name components.

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Cite this: Sorting Through the Confusion of Biologic Drug Names - Medscape - Aug 19, 2016.

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