FDA Yomwe Yavomerezedwa Esbriet ndi Ofev ya Idiopathic Pulmonary Fibrosis.
Mu October 2014, a FDA adalandira mankhwala awiri atsopano, pirfenidone (Esbriet) ndi nintedanib (Ofev), pofuna kuchiza matenda a idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis ndi matenda owopsa omwe amapha anthu ambiri omwe amapezeka nawo muzaka zingapo. Asanapeze pirfenidone ndi nintedanib, panalibe njira zina zothandizira mankhwala kwa anthu omwe ali ndi matenda oopsawa.
Kodi Idiopathic Pulmonary Fibrosis Ndi Chiyani?
Idiopathic pulmonary fibrosis ndi matenda aakulu kapena aatali omwe amawononga malo ang'onoang'ono m'mapapo (interstitia). Ngakhale kuti pali chiwerengero chochepa chodziwika bwino pa matendawa, bungwe la American Lung Association likulingalira kuti limapha pafupifupi 140,000 a ku America. Pamene ndikugwiritsira ntchito mabukuwa, ndinawona zowonjezereka zedi pamene matendawa amatanthauzidwa mopitirira malire (chonde tetezani pun), ndipo imakhudza kulikonse kwa anthu 14 ndi 28 pa 100,000. Anthu omwe ali ndi matendawa ali ndi zaka 50 kapena kupitirira, ndipo matendawa amakhudza amuna ambiri kuposa akazi.
Palibe amene amadziwa chomwe chimayambitsa idiopathic pulmonary fibrosis (ndicho chifukwa chake amatchedwa matenda a idiopathic ). Chimene tikudziwa ndi chakuti matenda oopsawa akuwonjezeka m'mapapu-mapapo ndi chiwalo chochepetsera. Zindikirani, idiopathic pulmonary fibrosis ndi matenda ochepetsa mapapo omwe amachepetsa mapapu.
Akapezeka, zaka zapakati pa moyo wa anthu omwe ali ndi matendawa ndi zaka 4 zokha.
Idiopathic pulmonary fibrosis imayambitsa kutupa ndi kusintha kwa mafinya (scarring) m'mapapo am'mapapo (parenchyma) omwe amagwiritsidwa ntchito mogwirizanitsa ndi mapuloteni a pulmonali mu alveoli. Mipukutu ya pulmonary mu alveoli ndizoonongeka; ma capillaries am'mapapo amathandizira kusintha kwa okosijeni ndikuyambitsa magazi olemera muthupi.
Mwa kuyankhula kwina, kwa anthu omwe ali ndi imodomic fibrosis, akusowa m'mapiko ammapiko omwe amatha kupopera mpweya wochokera mumlengalenga umene timapuma.
Idiopathic pulmonary fibrosis amavuta kupuma pambuyo poyesera. Zimayambitsanso chifuwa komanso kusintha m'mapapu pamaphunziro. Zizindikiro zambiri za matendawa ndi zowonongeka, komanso, kuphatikizapo kutopa, kutaya thupi ndi kugwila zala zala ndi zala. Maphunziro a CT apamwamba (ganizirani über-tsatanetsatane wa x-rays) asonyeze patchy kapena pied ndi "uchi" maonekedwe kumene kusinthasintha kwachitika. Kupanga mankhwala opangira opaleshoni kumapereka chitsimikizo cha matendawa. Pamene pulmonary fibrosis ikupita, imayambitsa mikhalidwe yowonongeka kapena yowonjezera kuphatikizapo kupuma, kulephera kwa mtima ndi kupatsirana kwapoponopang'ono .
Ngakhale sitikudziwa chomwe chimayambitsa matenda a idiopathic pulmonary fibrosis, tikudziwa kuti pali zifukwa zina zomwe zingayambitse matendawa:
- kusuta fodya
- matenda opatsirana ndi mapiritsi
- Kutsekemera kwa mpweya, utsi, fumbi ndi zina zina zazing'ono
- GERD (matenda opatsirana pogonana a reflux AKA osakwiya kwambiri)
- zojambula
Idiopathic pulmonary fibrosis ndi yotchuka chifukwa cha kusowa kwabwino komanso koyenera.
Ngakhale kuti anthu ena amakhalabe olimba kwa nthawi yayitali atatha kupeza kachilombo ka HIV, ambiri amadzipiritsa kapena amadzipweteka ngakhale atalandira chithandizo. Chithandizo chamakono chili ndi zizindikiro za matenda kapena kuyesa kuchepetsa kupweteka ndi kupweteka kwina. Prednisone, steroid, imagwiritsidwa ntchito pofuna kuthana ndi kutupa. Anthu ambiri omwe ali ndi pulmonary idiopathic pulmonary fibrosis amalandiranso mpweya wambiri wothandizira. Potsirizira pake, njira yokhayo yothandizira anthu omwe ali ndi idiopathic pulmonary fibrosis ndi kuika mapapo.
Kodi Pirfenidone (Esbriet) ndi Nintedanib (Ofev) ndi chiyani?
M'mayesero a zachipatala, pirfenidone (Esbriet) ndi nintedanib (Ofev) zasonyezedwa kuti kuchepetsa fibrosis kapena kuperewera, ndipo chifukwa chake matendawa amayamba kuchepa.
Pirfenidone ili ndi njira zambiri zomwe zingatheke ndipo ndi mankhwala am'kamwa. M'mayesero a katatu a Phase 3, pafupifupi theka la omwe ali ndi kachilombo ka pirfenidone kamene kamakhala ndi pang'ono mpaka kamodzi kameneka anawona kuchepa kwachitetezo. Njirayi ikuwonetsa kuchepa kwa matendawa. Ophunzirawo adalandira zina zabwino zomwe zikuphatikizapo kusintha kwa mtunda wa mphindi zisanu ndi chimodzi ndi kuchepetsa imfa (chiwerengero cha anthu akufa) pa nthawi ya phunziro la masabata 52. Zotsatira zovuta zothandizira mankhwala zinali zogwiritsidwa ntchito komanso zowonjezera zithunziensitivity, kupweteka m'mimba, kunyoza ndi kusanza.
Nintenanib ndi tyrosine-kinase inhibitor ndipo ngati pirfenidone ndi mankhwala amlomo. Pakati pa mitundu ina ya zamoyo, tyrosine kinase imakhudzidwa ndi kusintha kwakukulu komanso kofiira. M'mayesero amachilombo a Phase 3, monga pirfenidone, nintenanib inachepetsanso kuwonjezereka kwa matenda a idiopathic pulmonary fibrosis monga kuyesedwa kwa kuchepa kwa kuchepa kwa mphamvu yolimbikitsidwa. Zowonjezera zotsatira zimaphatikizapo kutsegula m'mimba, kunyoza, kusanza, kupweteka mutu, kuwonjezeka kwa magazi, ndi kuchulukitsa mavitamini a chiwindi (chizindikiro cha chiwindi chosagwira ntchito). Pomalizira pake, Ofev ndi mankhwala otsika kwambiri omwe sayenera kutengedwa panthawi ya mimba chifukwa choopa kubereka kwa mwana kapena imfa.
Kodi Pirfenidone (Esbriet) ndi Nintedanib (Ofev) Imatanthauza Chiyani kwa Inu?
Ngati inu kapena munthu amene mumadziŵa ali ndi idiopathic pulmonary fibrosis, kuvomerezedwa kwa pirfenidone (Esbriet) ndi nintedanib (Ofev) Ndizochitika zenizeni zamankhwala zomwe ziyenera kulandiridwa ngati uthenga wabwino. Komabe, nkhani zina zimafunika kuti zifotokozedwe musanayambe kumwa mankhwalawa. Choyamba, sizikudziwikiratu kuti pirfenidone ndi nintendanib ziyenera kugwiritsidwa ntchito padera kapena panthawi yomweyo pochiza matenda a idiopathic pulmonary fibrosis. Ngati tigwiritsidwa ntchito palimodzi, sitikudziwa kuti ndi mankhwala ati omwe ayenera kugwiritsidwa ntchito poyamba. Ngati tagwiritsidwa ntchito mosiyana, sitikudziwa ngati mankhwalawa adzawonetsa zotsatira kapena zoonjezera. Chachiwiri, sitikudziwa ngati anthu ena ali ndi chidwi makamaka ("responders") kwa mankhwalawa kapena onsewa. Chachitatu, sitikudziwa kuti mankhwalawa adzapitirirabe kuchepetsa kupitirira kwa mayendedwe a mphutsi.
Pamapeto pake, ngati inu kapena wokondedwa wanu muli ndi imodoka ya fibrosium, ganizirani zambiri zokhudza magulu othandizira matendawa ku American Lung Association kapena National Heart, Lung, ndi Blood Institute.
Zosankha Zosankhidwa
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"Kupuma kwa mpweya: chinthu chachikulu chomwe chimapangidwira ku matenda a mphuno ya idiopathic pulmonary fibrosis" ndi CJ Ryerson ndi HR Collard ochokera ku BMJ omwe anafalitsidwa mu September 2014. Anapezeka kuchokera ku PubMed pa 11/4/2014.