Products
Enzymes are commercially available as drugs in the form of tablets, lozenges, capsules, as well as injection and infusion preparations, among others. Many products are subject to prescription, but there are also some agents which are released for the OTC market.
Structure and properties
Therapeutic enzymes are usually proteins, i.e. polymers of amino acids, which are produced or obtained by biotechnological methods or by an extraction. Since they are usually not bioavailable orally, they are usually injected or infused. This is with the exception of digestive enzymes (e.g. lipase, amylase, cellulase, lactase), which are taken perorally, for example as tablets. Enzymes may be identical to the body’s own proteins, derived from them, artificially produced, or derived from other species. In addition to proteins, RNA can also be catalytically active. These are referred to as ribozymes.
Effects
Enzymes are biocatalysts that lower the activation energy of a chemical reaction and substantially increase the reaction rate. On the other hand, they have no effect on the reaction equilibrium. In this process, substrates are converted to products. The active site of the enzyme provides ideal conditions for the reaction. In pharmacy, enzymes are often used for substitution therapy. This means that they take over the function of an endogenous enzyme that is not produced or not produced sufficiently. In English, this is referred to as (ERT). For pharmacotherapy, the specific properties of an enzyme may also be of interest, for example, the degradation of mucus or of undesirable substances. For example, rasburicase breaks down excessive uric acid and collagenase from Clostridium histolyticum dissolves collagen.
Indications for use
Enzymes are used in medicine for numerous applications, especially for substitution therapy. Enzymes also play an important role as drug targets and in the synthesis of active pharmaceutical ingredients.
Dosage
According to the SmPC. Enzymes are usually administered perorally or parenterally.
Active ingredients (selection).
- Agalsidase (Replagal (alfa), Fabrazyme (beta))
- Alglucosidase alfa (Myozyme)
- Alpha-galactosidase
- Amylases (e.g., in pancreatin).
- Asfotase alfa (Strensiq)
- Cerliponase alfa
- Dornase alfa (Pulmozyme, a deoxyribonuclease).
- Elosulfase alfa (Vimizim)
- Galsulfase (Naglazyme)
- Glucarpidase (Voraxaze)
- Hyaluronidase
- Idursulfase (Elaprase)
- Imiglucerase (Cerezyme)
- Invertase
- Collagenase from Clostridium histolyticum (Xiapex, out of commerce).
- Lactase (Lacdigest, dietary supplement).
- Laronidase (Aldurazyme)
- Ocriplasmin (Jetrea)
- Pancreatin (mixture)
- Papain (Lysopain)
- Pegaspar gases (Oncaspar)
- Pegvaliase (Palynziq)
- Rasburicase (Fasturtec)
- Sebelipase alfa (Kanuma)
- Tilactase (Lacdigest, see under lactase).
- Velaglucerase alfa (Vpriv)
- Digestive enzymes
- Xylanases (non-therapeutic)
- Xylose isomerase (medical device)
Enzymes usually carry the suffix -ase.
