Zikuwoneka Monga - Koma Mafunso Khalanibe
Nkhani yowonekera ku New England Journal of Medicine chakumapeto kwa August, 2014 yathandiza kuti pakhale njira yatsopano yothandizira mtima wosalimba . Nkhaniyo ikufotokoza zotsatira kuchokera ku PARADIGM-HF phunziro, momwe odwala omwe ali ndi vuto la mtima amathandizidwa ndi mankhwala osokoneza bongo. Mankhwalawa, opangidwa ndi Novartis, ndi atsopano moti sanatchulidwebe - panthawiyi amatchedwa LCZ696.
LCZ696 kwenikweni ili ndi mankhwala awiri ogwirizanitsidwa palimodzi - valsartan (omwe amagwiritsidwa ntchito kwambiri ndi ARB inhibitor) ndi wothandizira, sacubitril. Sacubitril amagwira ntchito poletsa mazirasi a neprilysin , ndipo chifukwa chake magazi amatha kuwonjezeka. Chifukwa peptides ya natriuretic ikhoza kukhala yopindulitsa pamtima mtima, ofufuza adalemba kuti LCZ696 ikhoza kuthetsa zotsatira za odwala omwe ali ndi vutoli. Zotsatira za kafukufuku wa PARADIGM-HF zikusonyeza kuti ochita kafukufuku anali olondola.
Mu phunziro ili, odwala oposa 8000 omwe ali ndi mtima wokhotakhotakhota adalandizidwa kuti alandire LCZ696, kapena mankhwala othandiza kugwiritsa ntchito ACE inhibitor enalapril. Kwa odwala omwe anatenga LCZ696, patatha miyezi 27 chiopsezo cha kudwala matenda odwala matenda a mtima ndi chiopsezo cha imfa zonsezi zinachepetsedwa ndi pafupifupi 20%. Njira iyi yowonjezera, pa zomwe panopa zikuwoneka kuti ndizopindulitsa kwa mtima, sizodabwitsa.
Chifukwa Chiyani Phunziroli Ndilofunika?
Zotsatira za PARADIGM-HF ndi zofunika pa zifukwa ziwiri. Choyamba, zikusonyeza kuti mankhwala atsopano a LCZ696 ayenera kupereka chiyembekezo chatsopano kwa odwala ambiri omwe ali ndi mtima wolephera - atavomerezedwa kuti agwiritsidwe ntchito ndi FDA.
Ndipo chachiŵiri, phunziro ili likutsegula njira yatsopano yothetsera vuto la mtima.
Choncho, tikhoza kuyembekezera kuti mankhwala ena apangidwe kuti, monga LCZ696, aziletsa ma neyzysin.
Kodi LCZ696 Lidzakhala Liti?
Mankhwala atsopano sangathe kulembedwa mpaka apitiliza ndondomeko yovuta ya FDA. Poganiza kuti zonse zikuyenda bwino ndi ndemangayi, choyambirira tikhoza kuyembekezera kuti mankhwalawa adzalandiridwa kuti agwiritsidwe ntchito ingakhale nthawi mu 2015.
Kodi Pali Mavuto Omwe Ali ndi LCZ696?
Panthawiyi, phwando la PARADIGM-HF likukondedwa ngati njira yatsopano yothandizira mtima kulephera. Ndipo ife tonse tikuyembekeza kuti izo zikutanthauza kuti ziri choncho. Komabe, pali zifukwa zosachepera zitatu zomwe tiyenera kukhala ndi chidwi chathu panthawiyi.
Choyamba, "njira zatsopano" zimalengezedwa nthawi zonse pambuyo poyesedwa kuchipatala ndi mankhwala atsopano. Ndipo pamene nthawi zina zimatsimikiziranso kuti zenizeni zenizeni zakhala zikuchitika, zambiri zimachitika kuti chithandizo chatsopano chikhoza kupereka phindu lochepa, ndipo mwina sichikuyenda bwino, kuposa poyamba.
Chachiwiri, zaka zoposa khumi zapitazo mankhwala omwe amatchedwa nesiritide (Natrecor) adawonetsedwanso kuti akuwongolera mtima. Izi ndizofunikira chifukwa nyerere siinangowonjezera mwachindunji mapangidwe a peptides monga LCZ696; nyerere inali peptide ya natriuretic.
Zinatenga zaka zingapo, ndi mayesero owonjezereka, kuti asonyeze kuti nesiritid kwenikweni inali ndi phindu lokhazikika (ngati liripo) pochiza mtima kulephera. Mbiriyi mwina ikuyenera kukhumudwitsa chidwi chomwe tsopano chikufotokozedwa kwa LCZ696.
Ndipo Chachitatu. . .
Neprilysin ali ndi ntchito zingapo kuphatikizapo kuchepetsa magulu a natriuretic peptides, ndipo zina mwa ntchitozi ndi zopindulitsa. Makamaka, neprilysin ingathandize kupewa matenda ena okhudzana ndi kusonkhanitsa mapuloteni osayenera m'thupi, monga matenda a Alzheimer ndi amyloidosis , ngakhale khansa ya prostate . Choncho kuletsa neprilysin sikungakhale chinthu chabwino kwambiri padziko lonse.
Mukhoza kuwerenga zambiri za vuto ili pano.
- Pano pali ndondomeko ya LCZ696 (yomwe tsopano imatchedwa Entresto), yomwe inavomerezedwa ndi FDA mu July, 2015.
Zotsatira:
McMurray JJV, Packer M, Desai AS, ndi al. Angiotensin-neprilysin kulepheretsa kusokoneza mtima kwa mtima. N Engl J Med 2014; DOI: 10.156 / NEJMoa1409077.
Jessup M. Neprilysin chiletso-njira yatsopano yoperewera mtima. N Engl J Med 2014; DOI: 10.1056 / NEJMe1409898.
Nalivaeva NN, Belyaev ND, IA Zhuravin, IA, et al. Peptidase ya Alzheimer's Amyloid-Degrading, Neprilysin: Kodi Tingawalamulire? Magazini ya International Journal of Alzheimer's Volume Volume 2012 (2012), Article ID 383796. Ipezeka pa: http://dx.doi.org/10.1155/2012/383796 (yomwe inapezeka pa 9/2/2014).