Si Zamoyo Zonse Zomwe Zimagwira Ntchito Imodzi Pomwe Zimachiza IBD
Kalasi yatsopano kwambiri ya mankhwala omwe amagwiritsidwa ntchito pochizira kutukuka kumene amayamba chifukwa cha kutupa kwa matumbo (IBD) amatchedwa biologics. Komabe, izi ndi mankhwala ochuluka kwambiri, ndipo onse sagwira ntchito mofananamo kapena amapatsidwa mofanana. Ena amavomereza kuti azichita mtundu umodzi wa IBD, pamene ena amagwiritsidwa ntchito pochiza matenda a Crohn ndi matenda a zilonda zam'mimba.
Chifukwa mankhwala osokoneza bongo amachititsa chitetezo cha mthupi m'njira zosiyanasiyana (mwina chifukwa chomwe amagwira ntchito kwa IBD), anthu omwe amawatenga akhoza kuyamba kutenga matenda ena. Ndikofunika, choncho, pewani njira zowonetsetsa kuti chitetezo chilipo kuti muteteze matenda. Anthu omwe ali ndi IBD ayenera kulandira katemera , makamaka asanayambe biologic, koma katemera ambiri angaperekedwe pamene akugwiritsa ntchito biologic.
Kodi madokotala amasankha chojambulira chani kuti adzalangize odwala? Pali kusiyana kwakukulu pakati pa mankhwalawa, ndipo zinthu zambiri zimaganiziridwa. Izi zingaphatikizepo mphamvu (zomwe zimasiyana ndi mtundu wa matenda ndi siteji), mitengo, komanso inshuwalansi, mwa zina. Madokotala adzafunika kutenga mbali zonsezi ndikuziganizira, ndi zina, pakupanga wodwalayo mankhwala okhudza biologic.
M'munsimu muwone zochepa za zinthu za mitundu yosiyanasiyana ya mankhwala a biologic.
Odwala ndi madokotala adzafuna kuyeza zinthu zonsezi ndi ena asanapange chisankho.
Cimzia
Cimzia (certolizumab pegol) ndi chotupa cha nthenda yotchedwa necrosis factor (TNF) chomwe chinavomerezedwa mu 2008 kuti achulukire matenda a Crohn. Mu 2009 adavomerezedwa kuti azisamalira nyamakazi, komanso kuti azidwala nyamakazi ndi ankylosing spondylitis mu 2013.
Cimzia kawirikawiri amaperekedwa ndi jekeseni ndi siringi yotchuka kunyumba. Cimzia imapatsidwa ndi jekeseni ziwiri, zomwe zimayambidwa kumalo osungira pakatha masabata 0, 2, ndi 4. Pambuyo pake, jekeseni ziwiri zimaperekedwa milungu iwiri iliyonse. Njira ina ya Cimzia ndi ufa umene umasakanikirana ndiyeno imayikidwa mu ofesi ya dokotala. Zotsatira zoyipa zomwe zimachitika kawirikawiri ndi mankhwalawa ndi matenda opatsirana opuma (monga chimfine), matenda opatsirana (ngati chimfine), zilonda zam'mimba, ndi matenda a mkodzo.
Mfundo zazikulu za Cimzia:
- Cimzia amavomerezedwa kuti apeze matenda a Crohn
- Cimzia kawirikawiri amaperekedwa kunyumba ndi jekeseni
- Cimzia amaperekedwa poyamba katatu m'magulu awiri, masabata awiri pambali, ndikutsatiridwa ndi jekeseni 2 milungu iwiri iliyonse
- Zotsatira zoyipa zimaphatikizapo matenda opuma opatsirana, matenda opatsirana, mavalo, ndi matenda opangira mkodzo
- Cimzia ndi kalasi B pathupi mankhwala
- Kuchuluka kwa Cimzia kungadutse m'thupi
- Cimzia amafunika kukhala firiji
Entyvio
Entyvio (vedolizumab) , yomwe inavomerezedwa mu Meyi 2014, ndi yotsutsana ndi α4β7 integrin antagonist. Zimagwiritsidwa ntchito pogwiritsa ntchito α4β7 integrin, zomwe zimalepheretsa integrin kuti isawonongeke. Entyvio imavomerezedwa kuti igwiritsidwe ntchito kwa anthu akuluakulu omwe ali ndi matenda a Crohn kapena ulcerative colitis.
Entyvio nthawizonse imaperekedwa ndi kulowetsedwa, kaya ku ofesi ya dokotala, kuchipatala, kapena kuchipatala cholowetsedwa. Nthawi yothandizira Entyvio ndi 3 infusions anachita masabata awiri pambali. Pambuyo pake, infusions amaperekedwa pafupifupi masabata asanu ndi atatu. Zina mwa zotsatira zake zimaphatikizapo chimfine, kutentha kwapachipatala, kupwetekedwa mutu, kupwetekedwa mtima, kunyowa, kutentha thupi, kutopa, chifuwa, kupweteka kwanthawi yaitali, kupweteka, kuyabwa, matenda a sinus, ululu wa mmimba, ndi ululu wamapeto .
Mfundo zazikulu za Entyvio:
- Entyvio imavomerezedwa ku matenda a zilonda zam'mimba ndi matenda a Crohn
- Entyvio imaperekedwa ndi kulowetsedwa mu mazira oyambira 3, ndiyeno masabata asanu ndi atatu
- Zotsatira zoyipa zimaphatikizapo matenda (chimfine, chimfine, bronchitis, matenda a sinus); ululu m'magulu, kumbuyo, mmero kapena kumapeto; zizindikiro za kunyoza, malungo, kutopa, chifuwa, kapena kuyabwa; ndi kuthamanga
- Entyvio ndi kalasi B pathupi mankhwala
- Sitikudziwa panopa ngati Entyvio ikudutsa m'mawere
Humira
Humira (adalimumab) ndi wodwala monoclonal antibody ndi TNF inhibitor omwe amagwiritsidwa ntchito pochitira anthu ndi IBD. Amavomerezedwa kwa akuluakulu ndi ana opitirira zaka zisanu ndi chimodzi omwe ali ndi ulcerative colitis kapena matenda a Crohn. Humira anayamba kuvomerezedwa mu 2002, ndipo anawonjezera kuti agwiritsidwe ntchito mu Crohn's disease mu 2007 ndi ulcerative colitis mu 2012. Huma akhoza kuperekedwa kunyumba kudzera mu jekeseni. Odwala amaphunzitsidwa momwe angadzipatsire jekeseni (kapena angathe kuthandizidwa ndi wachibale kapena mnzanu). Anthu ena omwe ali ndi Huma akhoza kukhala ndi zomwe zimatchedwa site site reaction , zomwe zimakhala kutupa, kupweteka, kuyabwa kapena kufiira pamalo omwe mankhwalawa amayiramo. Izi kawirikawiri zimachiritsidwa pakhomo ndi mankhwala oundana kapena antihistamine (kusintha ma siteti sabata iliyonse kumathandizanso).
Mfundo zazikulu za Huma:
- Humira amavomerezedwa ku matenda a Crohn ndi matenda a ulcerative
- Humira amapatsidwa kunyumba ndi kudzipiritsa
- Humira ayamba ndi jekeseni 4, kenaka ndi jekeseni 2 masabata awiri kenako, kenaka jekeseni imodzi sabata iliyonse
- Zotsatira zoyipa zimaphatikizapo kupweteka kapena kupsa mtima pa malo opangira jekeseni ndi kumutu, kupweteka, ndi mseru
- Humira ndi kalasi B pathupi mankhwala
- Makanda obadwa ndi amayi omwe alandira Huma sayenera kulandira katemera wamoyo kwa miyezi isanu ndi umodzi
- Humira amafunika kuti azizizira firiji
Remicade
Chithandizo choyamba cha biologic chomwe chinavomerezedwa kuti chigwiritsidwe ntchito kwa anthu omwe ali ndi IBD ndi Remicade (infliximab) , yomwe inavomerezedwa mu 1998. Remicade ndi anti-monoclonal antibody yomwe ndi TNF inhibitor ndipo imaperekedwa kwa odwala kudzera mwa IV. Izi zikhoza kuchitidwa ku ofesi ya dokotala, koma kawirikawiri zimapezeka mu malo osungirako mankhwala, omwe ndi maofesi apadera opangidwa kuti apereke mankhwala a IV. Remicade ingagwiritsidwe ntchito pochiza matenda a Crohn kapena ulcerative colitis, ndipo imavomereza kuti ana ali aang'ono ngati 6, nthawi zina. Remicade imaganiza kuti ikugwira ntchito mwa anthu omwe ali ndi IBD chifukwa imaletsa TNF, yomwe ndi chinthu chomwe chimapangitsa kutupa thupi.
Mfundo zazikulu za Remicade:
- Remicade imaperekedwa ndi IV
- Remicade imavomereza matenda a Crohn ndi matenda a zilonda zam'mimba
- Mankhwala atatu oyambirira amaperekedwa (pambuyo pa mlingo woyamba, yachiwiri ndi masabata awiri kenako, lachitatu ndi masabata 4 pambuyo pake)
- Pambuyo pa mlingo woyambira, amaperekedwa pafupifupi masabata asanu ndi atatu (nthawi zina pakufunika)
- Zotsatira zoyipa zimakhala kupweteka m'mimba, kunyoza, kutopa, ndi kusanza
- Remicade ndi mankhwala a m'kalasi B
- Remicade samaoneka ngati ikupita mkaka wa m'mawere
Mwachidule
Simponi (golimumab) ndi TNF inhibitor yomwe imavomerezedwa kuchiza chilonda cha zilonda zam'mimba. Simponi anavomerezedwa choyamba mu 2009 kuti athetse nyamakazi ya nyamakazi, nyamakazi ya psoriatic, ndi ankylosing spondylitis . Mu 2013 adavomerezedwa kuchiza matenda a zilonda zam'mimba. Ankylosing spondylitis ndi matenda omwe angagwiritsidwe ntchito ndi ulcerative colitis, kutanthauza kuti mankhwalawa angagwiritsidwe ntchito pochiza matenda (onse). Chophweka chimaperekedwa kunyumba, kotero odwala amaphunzitsidwa ndi wothandizira zaumoyo momwe angadzipangire okha (kaya okha kapena thandizo). Zina mwa zotsatira zotsutsana ndi Simponi ndiko kupeza matenda omwe amachititsa matenda monga chimfine, zizindikiro ngati zilonda zam'mimba kapena laryngitis, ndi matenda a tizilombo ngati chimfine. Kukhala ndi ubweya wofiira, kupweteka, ndi kunyowa pa malo opangira jekeseni, omwe nthawi zambiri amathandizidwa ndi ayezi ndi antihistamines, ndi njira ina yomwe ingawonongeke.
Mfundo zazikulu za Simponi:
- Kugonjera kungobvomerezedwa kuti muchotse ulcerative colitis
- Chosavuta chimaperekedwa ndi jekeseni kunyumba
- Chosavuta chimayambira ndi jekeseni 2, kenaka ndikumapeto kwa masabata awiri pambuyo pake, ndi jekeseni imodzi masabata 4 pambuyo pake
- Zotsatira zoyipa zimaphatikizapo kupweteka kapena kupsa mtima pa malo opangira jekeseni ndi kupuma kwapadera kapena matenda opatsirana
- Chosavuta ndi mtundu wa B wodwala mankhwala
- Sitikudziwa panopa momwe Simponi idzakhudzire mwana wakhanda
- Simponi ayenera kukhala firiji
Stelara
Stelara (ustekinumab) ndi munthu wodwala wodwalayo wa monoclonal immunoglobulin. Choyamba chinalandiridwa mu 2008 monga chithandizo cha psoriasis ya plaque ndipo mu 2016 kukachiza matenda a Crohn. Stelara amayesetsa kuchepetsa kutupa kwa Crohn's disease yomwe imayambitsa kulumikiza interleukin (IL) -12 ndi IL-23, zomwe zimalingalira kuti zimathandizira pa kutukuka kwa kutupa m'mimba. Mlingo woyamba wa Stelara waperekedwa ndi kulowetsedwa, mu malo olowera kulowetsedwa kapena ofesi ya dokotala. Pambuyo pa kulowetsedwa koyamba, Stelara akhoza kutengedwa kunyumba ndi jekeseni yomwe imapatsidwa milungu isanu ndi itatu. Odwala akhoza kudzipangira jekeseni ataphunzitsidwa ndi wothandizira zaumoyo. Zina mwa zotsatira zofala kwambiri zomwe zimawonedwa ndi anthu omwe ali ndi matenda a Crohn ndi omwe amatsuka (nthawi yoyamba kulowetsedwa), kupweteka kapena kufiira pa malo opangira jekeseni, kuyabwa, ndi matenda monga chimfine, matenda a yisiti, bronchitis, matenda, kapena matenda a sinus.
Mfundo zazikulu za Stelara:
- Stelara amavomerezedwa kuti apeze matenda a Crohn
- Mankhwala opangira Stelara amaperekedwa ndi kulowetsedwa ndipo pambuyo pake amaperekedwa ndi jekeseni kunyumba
- Anthu omwe amawombera chifuwa ayenera kulankhula ndi adokotala za momwe angayankhire ndi Stelara
- Zotsatira zoyipa zimaphatikizapo matenda, kupatsirana kwa jekeseni, ndi kusanza
- Stelara ndi mankhwala a m'kalasi B
- Zimaganiziridwa kuti Stelara amapita m'kati mwa bere
- Stelara ayenera kukhala firiji
> Zotsatira:
> Janssen Biotech, Inc. "Njira Yowonjezera Mankhwala." May 2013.
> Janssen, Inc. " Stelara (ustekinumab) Kufotokozera Zomwe Mukudziwa ." Makhalidal.com Aug 2016.
> Mayi Kwa Mwana. "Certolizumab Pegol (Cimzia) ndi Kumimba." AmayiToBaby.org. Aug 2015.
> Takeda Pharmaceuticals, Inc. "Pafupi ndi Entyvio." Entyvio.com. 2015.
> UCB, Inc. " Guide ya mankhwala a Cimzia (Certolizumab Pegol) ." Cimzia.com. Apr 2016.