Mankhwala Osokoneza Bongo Osagwirizana Mofanana ndi Oleza Mtima Payekha
Nthenda ya TNF (tumor necrosis factor) inakhala njira yothandizira odwala matenda a nyamakazi kapena matenda ena a kutupa nyamakazi kuyambira mu 1998 pamene Enbrel (etanercept) inali yovomerezedwa ndi FDA. Zina mwa mankhwala osokoneza bongo akhala akuvomerezedwa ndi kugulitsidwa.
Mankhwalawa ndi TNF, Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab), Simponi (golimumab) ndi Cimzia (certolizumab pegol).
Palinso mankhwala ena a biologic, monga Orencia (abatacept), Rituxan (rituximab), Actemra (tocilizumab), ndi Kineret (anakinra) omwe sagwirizane ndi TNF.
Ngati mukuchiritsidwa ndi TNF, zingakhale zofunikira kuti mutembenuzire ku chojambulira china cha TNF kapena mankhwala enaake pa nthawi ina. Zifukwa zomveka zoyenera kusintha zingakhalepo:
- Yankho losavomerezeka kuchipatala
- Zotsatira zovuta za mankhwala
- Kuchepetsa mphamvu pa nthawi
Tinapempha katswiri wa zinyama Scott J. Zashin, MD mafunso ochepa okhudza kusintha kusintha kwa TNF.
- Kodi n'zotheka kuti wodwala akhale ndi yankho labwino ku chojambulira cha TNF kapena ali ofanana?
- Kodi wodwalayo angabwererenso ku thifini ya TNF atasiya?
Dr. Zashin anayankha kuti, "Odwala 70 pa 100 alionse omwe ali ndi matenda a nyamakazi omwe amayamba imodzi mwa TNF, amatha kusintha kwambiri mkhalidwe wawo. Odwala ambiri adzapindula pamene methotrexate (Rheumatrex, Trexall) kapena DMARD anti-rheumatic drug) akuphatikizidwa ndi blocker ya TNF.
Ngati wodwala sakuyankha kuchitetezo cha TNF pambuyo pa miyezi itatu, kusintha kwa wina kudzawonjezera mwayi wawo wopindulitsa. Ndipotu, ngakhale wodwalayo asayankhire mankhwala osokoneza bongo a TNF, zingakhale zothandiza kuyesa katatu. "
Zoonadi, zotsatira zofukufuku (zomwe zinatulutsidwa mu June 2010 mu Rheumatology) zinamveka kuti odwala omwe ali ndi spondyloarthritis omwe sankamvetsera ku Enbrel ya Remicade monga oyamba, adayankha Huma atasintha, mosasamala chifukwa chake anasintha.
Kuphunzira kwina kosangalatsa, kofalitsidwa mu Clinical and Experimental Rheumatology mu 2013, kunasonyeza kuti odwala omwe ali ndi spondyloarthritis amatha kukhala ndi TNF blockers kuposa odwala nyamakazi, makamaka chifukwa cha ankylosing spondylitis magulu a odwala. Ndi nthenda yamagazi ndi spondyloarthritis, odwala adatha kumamatira ndi Enbrel ndi Huma poyerekeza ndi Remicade.
Dr. Zashin adanenanso kuti, "Ambiri a rheumatologists sanagwiritse ntchito Kineret kuti athetse vuto la nyamakazi chifukwa cha kuchepa kwake ndipo akuyenera kuyika tsiku ndi tsiku. Komabe, Kineret yakhala yothandiza kwambiri kwa odwala omwe apezeka kuti ali ndi nyamakazi ya mwana, yotchedwa Still's disease . "
Komanso, malinga ndi Dr. Zashin, pamene odwala omwe adasiya chithandizo ndi Enbrel ndi Huma akhoza kubwerera kuchipatala popanda nkhawa, omwe achoka Remicade kwa nthawi yayitali akukumana ndi chiopsezo chotengeka.
Zotsatira:
Kuchokera ku infliximab kapena enanercept kwa adalimumab mu odwala omwe sagonjetsedwa kapena osagwirizana ndi spondyloarthritis: kufufuza kwa zaka 4. Spesi. A. et al. Rheumatology (Oxford). June 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20223813
Kupulumuka kwa mankhwala oyamba a anti-TNF mawotchi kwa odwala matenda a nyamakazi ndi spongeyrthritis ya seronegative: kufufuza kuchokera ku database ya MonitorNet. Scire CA ndi al. Kachipatala ndi Zofufuza za Rheumatology. November-December 2013.
http://www.ncbi.nlm.nih.gov/pubmed/23981363
Yankho, mbali ina, loperekedwa ndi Scott J. Zashin, MD, pulofesa wothandizira wathandi ku University of Texas Southwestern Medical School, Division of Rheumatology, ku Dallas, Texas. Dr. Zashin nayenso akupita kuchipatala ku chipatala cha Presbyterian ku Dallas ndi Plano. Iye ndi mnzanga wa American College of Physicians ndi American College of Rheumatology ndi membala wa American Medical Association. Dr. Zashin ndi mlembi wa Arthritis Popanda Mavuto - Chozizwitsa cha Anti-TNF Blockers ndi wolemba wa Matenda a Matenda a Nyamakazi.