Aimovig ndi anti-monoclonal antibody yomwe imalepheretsa migraines
Pali mitundu iwiri ya mankhwala a migraine: kuchotsa mimba kapena kuteteza. Kuchotsa mimba kumagwiritsidwa ntchito panthawi ya migraine, ndi cholinga choyimitsa. Triptans ndi NSAID monga acetaminophen ndi ibuprofen (Advil) ndizochotsa mimba.
Mankhwala othandiza amayesetsa kuchepetsa kupweteka kwa mutu wa mutu wa mutu wa migraine. Mankhwalawa amagawidwa kwambiri ngati mankhwala odziteteza odwala migraine (OMPMs) komanso amawadwalitsa, anticonvulsants, ndi beta-blockers.
M'nkhani ya November 2017 yomwe inafalitsidwa mu New England Journal of Medicine , Goadsby ndi olemba mabuku anafufuza luso la Aimovig ku (erenumab) pofuna kuteteza migraine. Mosiyana ndi OMPM zamakono, Aimovig ndi mankhwala opangidwa ndi biologic-anti-monoclonal antibody. Kwenikweni, Aimovig imalepheretsa migraines mwa kulepheretsa puloteni ya calcitonin yokhudzana ndi majeremusi (CGRP) receptor, yomwe imagwirizanitsidwa ndi migraine activation.
Mayesero Aimovig Anali Ndani?
Pakati pa zochitika zapakati pa Gawo 2 ndi Gawo 3, Aimovig wakhala akuyesedwa kwa odwala omwe ali ndi matenda osokoneza bongo.
Mitsempha ya m'magazi imatchulidwa kuti ndi osakwana 15 migraine kapena masiku ammutu pamwezi, mwina kapena opanda. Migraine yosatha imafotokozedwa ngati masiku osachepera 15 pamutu pa mwezi. Masiku osachepera asanu ndi asanu ndi atatu awa ndi masiku a migraine ali ndi kapena opanda aura.
Mitsempha yamaganizo ndi yofala-pafupifupi 90 peresenti ya anthu omwe ali ndi migraines ali nawo.
Pakati pa 5 peresenti ndi 8 peresenti ya anthu omwe ali ndi migraine amakhala ndi migraines osatha.
Pazoyesa
Mu nkhani ya November 2017 yomwe inafalitsidwa mu New England Journal of Medicine , Goadsby ndi olemba anzawo anafufuza luso la Aimovig pofuna kuteteza migraine.
Mu phunziro ili, panali 995 anthu akuluakulu omwe adagawidwa m'magulu awiri oyesera ndi gulu lolamulira.
Gulu lolamulira linalandira jekeseni wa placebo, ndipo magulu oyesera analandira mwina 70 mg kapena 140 mg subcutaneous injection ya Aimovig, yomwe imayikidwa ngati miyezo isanu ndi umodzi yosachepera masabata anayi.
Malingana ndi olembawo, mayendedwe onsewa "adachepetsanso mafupipafupi a migraine, zotsatira za migraines pazochitika za tsiku ndi tsiku, komanso kugwiritsa ntchito mankhwala ovuta a migraine kwa miyezi isanu ndi umodzi."
Pachiyambi, chiwerengero cha masiku a migraine amachitika mwezi uliwonse ndi ophunzira mu phunziroli anali masiku 8.3. Pakati pa miyezi inayi ndi isanu ndi umodzi, chithandizo cha masiku a migraine chinachepa ndi 3.2 ndi 3.7 mu 70-mg Aimovig ndi 140-mg Aimovig magulu.
Pakati pa chiyambi cha phunziroli ndi miyezi inayi kapena isanu ndi umodzi ya chithandizo, mu 70 mg mgulu, 43.3 peresenti ya odwala anapeza kuchepetsa kuchepa kwa 50 peresenti ya masiku a migraine omwe amapezeka mwezi uliwonse.
Pakati pa chiyambi cha phunziroli ndi miyezi inayi kapena isanu ndi umodzi ya chithandizo, mu 140-mg gulu, 50 peresenti ya odwala anapeza kuchepa kwa 50 peresenti ya masiku a migraine omwe amapezeka mwezi uliwonse.
Pakati pa chiyambi cha phunziroli ndi miyezi inayi kapena isanu ndi umodzi yothandizira, anthu omwe amalandira malowa, 26.6 peresenti anapeza kuchepa kwa 50 peresenti ya masiku a migraine omwe amapezeka mwezi uliwonse.
Chiwerengero cha masiku omwe odwala ankagwiritsa ntchito mankhwala ochiritsira kuti athetse migraines mwachiwisi chinachepetsedwa ndi 1.1 masiku mu 70-mg gulu ndi masiku 1.6 mu 140-mg gulu poyerekeza ndi 0.2 masiku mu malo a placebo.
Kusokonezeka kwa ntchito za tsiku ndi tsiku kumachititsa kuti migraine iwonongeke. Pogwiritsira ntchito mafunso, ofufuza adafufuza kusintha kwa ntchito za tsiku ndi tsiku. Anapeza kusintha kwakukulu kwa iwo omwe alandira Aimovig.
Zotsatira Zoipa ndi Zoperewera
Ngakhale zovuta za Aimovig zinanenedwa ndi ambiri mwa ophunzira, zochitika zovuta izi sizinali zosiyana ndi omwe alandira malo okhalamo.
Zowonjezereka, anthu ambiri omwe amalandira 70 mg ya Aimovig adamva ululu pa malo opangira jekeseni kusiyana ndi omwe anali mu gulu lolamulira.
Zitsanzo za zovuta zambiri zomwe zimakhala zovuta zimaphatikizapo kuzizira, kutentha kwapakati, matenda a sinusitis.
Chinthu chimodzi chokha cha phunziroli chinali chakuti ochita kafukufuku sanaphatikize odwala omwe sanapeze chithandizo cha mankhwala kuchokera ku magulu awiri kapena kuposa a OMPM.
Komabe, ochita kafukufuku anaphatikizapo odwala omwe anasiya OMPM chifukwa cholephera kugwira ntchito, kusowa yankho lokhazikika, kapena zotsatira zoipa zosasangalatsa. Ndipotu, 38.7 peresenti ya odwala mu chitsanzocho sanayambe apindulapo ndi OMPM.
Komanso, molingana ndi Goadsby ndi alembi ena:
Kuwonetseratu kwabwino kunawonetsedwanso mofanana mu mayesero a chigawo chachiŵiri cha erenumab okhudzana ndi odwala omwe ali ndi matenda a migraine osatha, omwe 68 peresenti ya odwala anali atasiya mankhwala othandizira migraine chifukwa cha kusowa kwa mphamvu kapena zosavomerezeka.
Potsatira zotsatira za mayesero ena a Phase 2 ndi a Phase 3 omwe akuyesa kugwiritsa ntchito Aimovig kwa omwe ali ndi migraine yosatha komanso yowopsya, zikuwoneka kuti Aimovig angathandize kuteteza matenda osokoneza bongo.
Kafufuzidwe kafukufuku amafunika kuchitidwa pofuna kuchepetsa chitetezo cha nthawi yaitali cha Aimovig, komanso momwe zingathere nthawi yayitali.
Momwe Aimovig Akugwiritsira Ntchito Mpaka kwa OMPM
Kusiyanitsa kwakukulu pakati pa Aimovig ndi OMPM ndikuti Aimovig amagwiritsa ntchito makamaka njira zochizira matenda zomwe zimathandiza kuti munthu asinthe.
Osati kufufuza mokwanira kuti ayerere zotsatira za Aimovig ndi mankhwala ena oteteza mutu wa mutu wa migraine. Komanso, palibe kafukufuku wochuluka wofufuza momwe mphamvu za OMPM zimakhalira.
Malingana ndi American Academy of Neurology:
Umboni sungapezekenso pakupanga kufanana kwakukulu pakati pa antchito angapo mkati mwa gulu limodzi; umboni woterewu ukhoza kumvetsetsa bwino za machitidwe abwino ndi kulekerera pazochitika zosiyanasiyana zochiritsira. Phunziro likufunika kuti mudziwe bwinobwino ngati mankhwala othandiza ndi othandiza komanso momwe mankhwala ayenera kukhalira.
Chiwerengero chochepa cha maphunziro afufuza momwe mphamvu za OMPM zimakhalira. Malingana ndi AAN, pali umboni wamphamvu kapena wovomerezeka wothandizira kuthandizira kwa mankhwala otsatirawa:
- Divalproex sodium, sodium valproate, ndi topiramate (antiepileptic drugs)
- Metoprolol, propranolol, timolol, atenolol, ndi nadolol (beta-blockers)
- Amitriptyline ndi venlafaxine (antidepressants)
Kuwonjezera apo, gabapentin, lamotrigine, clomipramine, ndi fluoxetine, zomwe zimaperekedwa kuti zigwiritse ntchito migraine kupewa, mwina sizigwira ntchito popewera migraines.
Zindikirani, mankhwala ochiritsidwa ndi mankhwala okhudzana ndi khunyu amafunika kusamalidwa mosamala chifukwa cha kuperewera kwa chiwindi, chiwindi, kulephera, komanso zotsatira zoopsa za chiberekero. Komanso, divalproex sodium ikhoza kupangitsa kulemera. Pakalipano, zikuwoneka kuti Aimovig sakhala ndi zotsatirapo zoterezi.
Chinthu chimodzi chimene timadziwa za OMPM ndi chakuti kumatira kumakhala kochepa. M'mawu ena, anthu ambiri omwe amamwa mankhwalawa amasiya kumwa mankhwalawa.
Mu kafukufuku wobwerezabwereza wofalitsidwa ku Cephalagia mu 2015, Hepp ndi anzake adagwira ntchito zogwira ntchito zosiyanasiyana za OMPM 14 zochizira matendawa. Pakati pa odwala 8688, miyezi isanu ndi umodzi yothandizira anthu amatha kukhalapo pakati pa 26 ndi 29 peresenti. Pakadutsa miyezi 12, ziŵerengero zothandizira zatsikira pakati pa 17 peresenti ndi 20 peresenti.
Malingana ndi olembawo:
Ngakhale zifukwa zosagwirizana nazo sizinagwiridwe ndi deta zadzinenedwa, kafukufuku amene asindikizidwa kale amasonyeza kuti zochepa zowonjezera zikhoza kuchitika chifukwa cha zifukwa zingapo, kuphatikizapo zotsatirapo ndi / kapena kuchepa kwa OMPM. Kuwonjezera pamenepo, malangizo a AAN amatsindikiranso kuti ma ochepa chabe a OMPM alipo omwe ali ndi umboni wabwino wothandiza kuti athetse mutu wa mutu wa migraine.
N'zochititsa chidwi kuti ofufuza anapeza kuti ma 14 OMPM anayesedwa, amitriptyline, nortriptyline, gabapentin, ndi divalproex anali ndi chiwerengero chochepa chotsatira poyerekeza ndi topiramate.
Kusokoneza maganizo
Pano pali nkhani yaikulu ndi migraines: Sitikumvetsa bwino momwe amagwirira ntchito. Popanda kumvetsetsa bwino njira za matendawa, zimakhala zovuta kukhazikitsa njira zatsopano zothandizira komanso njira zothandizira kuti zitha kulondola.
Taonani ndime yotsatirayi m'nkhani yowonongeka ya 2013 yotchedwa "Migraine: boma la ubongo":
Maganizo a migraine pathogenesis akhala akuyang'ana pa dera loyambirira la chiyambi monga kufalitsa maganizo ku cortex kapena 'generraine generator' mu ubongo. Koma kusintha kwa msasa kwa migraine kumasonyeza kusinthika kamodzi komwe kumagwira ntchito m'madera ambiri a ubongo, ndipo sizikuwoneka kuti pali dera limodzi lokha lomwe amatha kulumikiza migraine mwa odwala onse.
Monga Aimovig, Cefaly cholinga chake ndi kusokoneza mwachindunji tizilombo toyambitsa matenda a migraine mwa kuyang'ana njira. Mosiyana ndi Aimovig, yomwe imapatsidwa ngati jekeseni, Cefaly ndi chipangizo chogwiritsira ntchito zizindikiro zomwe zimayikidwa pamphumi. Zimayambitsa mitsempha yamtunduwu, yomwe imalingalira kuti imathandizira kwambiri migraines.
Cefaly adavomerezedwa ndi FDA posachedwapa osati njira yothetsera vuto komanso kuthandizidwa kwambiri. Zimabwera mwa mitundu itatu: Cefaly Acute, Cefaly Prevent, ndi Cefaly Dual. (Cefaly Dual ili ndi njira zochizira komanso zochitiratu chithandizo cha migraines.)
Malinga ndi omwe amapanga, Cefaly Prevent imapereka mphamvu yapamwamba yomwe ingagwiritsidwe ntchito tsiku ndi tsiku kuti iteteze migraine.
M'mayesero a zachipatala, omwe anachitika pakati pa 2009 ndi 2012, omwe amalandira Cefaly mankhwala opewera migraines anali ndi kuchepa kwakukulu m'masiku onse a migraine ndi mutu pambuyo pa miyezi itatu yogwiritsidwa ntchito.
Makamaka, odwala omwe analandira chithandizo cha Cefaly anakumana ndi 29.7 peresenti yocheperapo masiku a migraine ndipo 32.3 peresenti yochepa masiku opweteka. Komanso, 38.2 peresenti ya odwala omwe akulandira Cefaly amachepetsa kuchepa kwa 50 peresenti m'mwezi uliwonse wa migraine.
Kuwonjezera pa kuchepa kwa migraine ndi masiku ammutu, omwe amagwiritsira ntchito Cefaly amafunikanso mankhwala ochepetsa anti-migraine ("mankhwala opulumutsa"). Zindikirani, panalibe zotsatira zovulaza kwambiri kwa omwe amalandira chithandizo cha Cefaly.
Pa kafukufuku wochitidwa malonda wochitidwa ndi Cefaly, odwala 53 peresenti omwe analandira chipangizocho anali okondwa nacho. Ndi anthu 4 peresenti ya ogwiritsa ntchito omwe amanena kuti sakhutira ndi kuwonetsa zotsatira zochepa zazing'ono, monga kugona, kupweteka mutu, kapena kugwedeza chifukwa cha chipangizo. Monga momwe zinalili ndi mayesero a chipatala, panalibe zotsatira zoopsa zowonjezereka kuposa mankhwala a Cefaly.
Mawu Ochokera
Ngakhale kuti sitikumvetsa bwino momwe migraines amagwirira ntchito, njira zatsopano monga mankhwala a bizinesi Aimovig, komanso chipangizo chodzidzimutsa matenda a Cefaly, chikufuna kusokoneza njira za matendawa. Aimovig sayenera kuvomerezedwa ndi FDA, koma Cefaly alipo. Ngati mukukhudzidwa ndi mankhwalawa kapena njira zina zothandizira, kambiranani ndi katswiri wanu wa zamagulu.
> Zotsatira:
> Charles, A. Migraine: boma la ubongo. Malingaliro Amakono mu Neurology. 2013; 26: 235-239.
> Kulemba kwa De Novo Kufunsira kwa Cefaly Device . FDA.
> Goadsby PJ, et al. Mayesero Oletsedwa a Erenumab kwa Miguine Yoposera. The New England Journal of Medicine. 2017; 377: 2123-2132.
> Hepp Z, ndi al. Kugonjera mankhwala opatsirana pogwiritsira ntchito migraine mwa odwala omwe ali ndi matenda aakulu a migraine, Cephalagia. 2015; 35: 478-488.
> Wotchera F, Penning S, Schoenen J. Transcutaneous Supraorbital Mitsempha Yokhumudwitsa (t-SNS) ndi Cefaly Device for Migraine Prevention: A Review of Available Available. Ululu ndi Thandizo. 2015; 4: 135-137.