Dera la FDA lovomerezeka lochepetsera kugwilitsila nchito mankhwala otchedwa Gut Fat mwa 15-18%
Kulemba
Egrifta (tesamorelin) ndi jekeseni yowonongeka-hormone-release hormone (GHRH) yomwe inavomerezedwa ndi US Food and Drug Administration (FDA) mu November 2010 pofuna kuchiza lipodystrophy yogwirizana ndi HIV .
About Lipodystrophy Yogwirizana ndi HIV
Lipodystrophy yokhudzana ndi kachirombo ka HIV ndi chikhalidwe chodziwika ndi kugawidwa kwakukulu kwa mafuta a thupi.
Matendawa amawoneka ndi kupotoka kwa nkhope, matako, kapena mapeto, nthawi zambiri kumapangitsa kuti mafuta aziwonjezeka pamimba, pamabere, kapena kumbuyo kwa khosi (zomwe zimatchedwa "buffalo hump" monga mu mawonekedwe).
Lipodystrophy yokhudzana ndi HIV yakhala ikugwirizanitsidwa ndi mitundu ina ya mankhwala opatsirana pogonana , kuphatikizapo protease inhibitors (PIs) ndi zina zotchedwa nucleoside reverse transcriptors (NRTIs) monga Zerit (stavudine) ndi Videx (didanosine). Chikhalidwechi chikhoza kukhala chifukwa cha kachilombo ka HIV, makamaka kukhudza odwala omwe sanayambe kulandira ma ARV.
Ngakhale lipodystrophy ikuwoneka mochepa kwambiri kwa anthu omwe ali ndi kachilombo koyambitsa matendawa chifukwa chakuti ma antiretroviral amayamba kubadwa, amakhalabe vuto chifukwa chikhalidwecho sichitha kusintha mosavuta ngati chimachitika ndipo ngakhale mankhwalawa akuyimitsidwa.
Chithandizo Chachidziwitso ndi Zotsatira
Odzidzimutsa amasonyeza odwala kachilombo ka HIV makamaka kuti asachepetsa mafuta owonjezera (ie mafuta, omwe amapezeka m'mimba ndi m'mimba mwawo).
Zikuwoneka kuti sizikukhudzidwa ndi lipoatrophy (kutayika kwa mafuta) kwa nkhope, zikopa kapena miyendo, kapena kuwonjezera mafuta pamabere kapena kumbuyo kwa khosi.
Zochita zogwiritsira ntchito polimbikitsa chigoba cha pituitary kuti chimasulire hormone ya kukula kwa anthu (HGH) , zomwe zimadziwika kuti zimapangitsa kuti lipolysis (ie, kupweteka kwa lipids ndi triglycerides).
Kafukufuku wasonyeza kuti mankhwala a Egrifta angachepetse mafuta a m'mimba mwa pakati pa 15% ndi 17% poyerekeza ndi CT scan. Mayesero owonjezereka mu 2014 asonyeza kuti Egrifta akhoza kuchepetsa mafuta ochuluka kuzungulira chiwindi ndi 18%.
Mlingo ndi Utsogoleri
Mlingo waukulu wa Egrift ndi 2mg jekeseni subcutaneously (pansi pa khungu) kamodzi tsiku ndi tsiku. Ndikoyenera kuti Egrifta adzalidwe mu mimba pansi pa phokoso. Malo osungira jekeseni nthawi zambiri amathandiza kuchepetsa kupweteka ndi / kapena kuuma kwa khungu.
Zokometsera zimayambitsanso kachilombo koyambitsa mankhwala pogwiritsa ntchito madzi osabvundi, omwe amatha kuperekera muzitsulo zosiyana ( chithunzi ). Mukachiyanjanitsanso, mankhwalawa ayenera kugwiritsidwa ntchito mwamsanga. Egrifta yosasinthidwa iyenera kusungidwa mu firiji pakati pa 36 o F ndi 46 o F (2 o C ndi 8 o C).
Kuwongolera sikusonyezedwe pofuna kukonza kulemera kwa kulemera.
Nthawi ndi Kuwunika Mankhwala
Popeza kuti zotsatira za nthawi yaitali kapena zopindulitsa za mankhwala sizidziwike bwino, kuyesetsa kulikonse kuyenera kuyang'anira zotsatira za mankhwala pogwiritsa ntchito CT scan kapena kutalika kwa mitsempha yozungulira. Ngati wodwala sakuwonetseratu kuchepa kwa njira izi, ndiye kuti ayenera kuganizira za kusiya mankhwala.
Nthawi yonse ya mankhwala ayenera kuchitidwa mwachindunji ndi katswiri wa kachilombo ka HIV / AIDS omwe akupezeka pa chithandizo cha GHRH, kapena pakuyankhulana pakati pa katswiri wa kachilombo ka HIV / AIDS ndi katswiri wodziŵa za matenda a HIV / AIDS.
Masewu a shuga ayenera kuyang'anitsitsa nthawi zonse pakutha mankhwala chifukwa Egrifta angayambitse kusagwirizana kwa mtundu wa shuga, kuika wodwalayo pangozi yowonjezera ya matenda a shuga .
Zotsatira Zowonongeka (zikuchitika pa odwala osachepera 2%)
- Zowawa zofanana (arthralgia)
- Ululu pamapeto
- Kupweteka kwa minofu (myalgia)
- Kufiira kwa malo osokoneza, kutupa kapena kupweteka
- Kusinkhasinkha kwa khungu (paresthesia)
- Kusowa khungu kwa khungu (hypoesthesia)
- Rash
- Flushing
- Kuyamwa (pruritis)
- Nausea
- Kuthamanga
Kuyanjana kwa Mankhwala
Kuchita zinthu molakwika kumagwirizana ndi mankhwala otsatirawa, kuchepetsa kuyamwa / kuperekedwa kwa zonse zomwezo komanso mankhwala ophatikizapo:
- Mankhwala otsika kwa cholesterol: Zocor (simvastatin)
- Mankhwala opatsirana pogonana a HIV: Norvir (ritonavir)
Kusamvana ndi kulingalira
Sitiyenera kuperekedwa kwa aliyense amene ali ndi vuto lachibwibwi , kaya atangoyamba kumene kupeza kapena kubwereza monga HGH angapangitse kukula kwa chifuwa cha mimba (chotupa). Kuganizirana mosamala kumafunika kwa odwala omwe ali ndi zotupa zosalimba kapena omwe ali ndi mbiri ya mankhwala osokoneza bongo kapena okhazikika, poyeza zotsatira zomwe zingakhalepo potsata zoopsa.
Kuchita zinthu molakwika kumatsutsana ndi odwala omwe ali ndi opaleshoni yachipatala, chotupa choyambitsa chifuwa, chithunzithunzi, kutsegula mutu, kapena kuchotsa opaleshoni ya hypophysectomy.
Zomwe zimagwirizanitsa ndi amayi omwe ali ndi kachilombo ka HIV ngati minofu yowonongeka amafunika kuwonjezeka pa nthawi ya mimba ndipo kuchepetsa kulikonse mwa njira ya GHRH mankhwala kungapweteke mwanayo. Ngati mimba ikupezeka, pewani mankhwala oyenera.
Zovuta sizidziwika ngati wodwalayo ali ndi hypersensitivity kwa tesamorelin kapena diuretic Osmitrol (mannitol).
Kuganizira mosamalitsa kuyeneranso kuti anthu omwe ali ndi matenda a shuga monga Egrifta angathe kuwonjezera kuchuluka kwa insulini (factor 1) (IGF-1) . Kuwunika kawirikawiri kuyenera kuchitidwa pofuna kuzindikira chitukuko kapena kuwonjezeka kwa matenda a shuga (retardopathy).
Zotsatira:
US Food and Drug Administration (FDA). "FDA imavomereza kuti Erika amatha kuchiza Lipodystrophy kwa odwala HIV." Silver Spring, Maryland; ndondomeko yofalitsa yomwe inatulutsidwa pa November 10, 2010.
Stanley, T .; Feldpausch, M .; O, J ;; et al. "Zotsatira za tesamorelin pa mafuta oopsa omwe ali ndi kachilombo ka HIV: mayesero osayenerera, omwe amaweruzidwa ndi placebo." Journal ya American Medical Association (JAMA). July 23-30, 2014; 312 (4): 380-389.