Harvoni ndi mlingo wokhazikika womwe umagwiritsidwa ntchito pochiza matenda aakulu a chiwindi cha chiwindi (HCV) . Mankhwala awiri omwe amaphatikizapo Harvoni (ledipasvir, sofosbuvir) ntchito potseka onse mapuloteni (NS5A) ndi enzyme (RNA polymerase) ndi yofunika kwambiri kuti kachilombo ka HIV kachiwirirenso.
Harvoni inavomerezedwa pa October 10, 2014, ndi US Food and Drug Administration (FDA) kuti agwiritsidwe ntchito kwa anthu akuluakulu zaka 18 kapena kuposerapo ndi matenda a HCV 1, kuphatikizapo omwe ali ndi chiwindi .
Harvoni imavomerezedwa kuti igwiritsidwe ntchito pa odwala omwe kale sanatengedwe (odwala-naïve) odwala, komanso omwe ali ndi mayankho osankhidwa kapena osayankhidwa ku mankhwala a HCV asanakhalepo.
Harvoni ndi mankhwala oyamba a HCV omwe amavomerezedwa ndi FDA omwe sayenera kutengedwa ndi pegylated interferon (peg-interferon) kapena ribavirin (mankhwala awiri omwe amagwiritsidwa ntchito pophatikizapo mankhwala a HCV, onse omwe anali ndi mauthenga apamwamba a poizoni).
Harvoni akuti ndi mankhwala ochizira pakati pa 94% ndi 99%, pamene mayesero a Phase II atulutsa 100% mankhwala ochiza odwala omwe ali ndi HIV ndi HCV.
Mlingo
Pulogalamu imodzi (90mg / 400mg) imatengedwa tsiku ndi tsiku kapena popanda chakudya. Mapiritsi a Harvoni ali ofanana ndi diamondi, a ginger, ndi a film, omwe ali ndi "GSI" mbali imodzi ndi "7985" pambali inayo.
Kulemba Malangizo
Harvoni akulamulidwa pa maphunziro a masabata 12 mpaka 24, malinga ndi zotsatirazi:
- Kuchiza-naïve kapena popanda chibwibwi: masabata 12
- Kuchiza-kukumana popanda chibwibwi: masabata 12
- Kuchiza-kumadziwika ndi matenda a cirrhosis: masabata 24
Kuwonjezera pamenepo, maphunziro a masabata asanu ndi atatu angathe kuganiziridwa ndi odwala-naïve odwala popanda chibwibwi omwe ali ndi kachilombo koyambitsa ma HCV oposa 6 miliyoni / mL.
Zotsatira Zogwirizana
Zotsatira zambiri zomwe zimakhudzana ndi kugwiritsidwa ntchito kwa Harvoni (kumachitika odwala 10% kapena ochepa) ndi:
- Kutopa
- Mutu
Zina zowononga zotsatira (pansi pa 10%) zimaphatikizapo kusuta, kutsegula m'mimba, ndi kusowa tulo.
Kuyanjana kwa Mankhwala
Zotsatirazi ziyeneranso kupeŵa pogwiritsa ntchito Harvoni:
- Mankhwala opatsirana pogwiritsa ntchito mankhwala a Rifampin: Mycobutin, Rifater, Rifamate, Rimactane, Rifadin, Priftin
- Anticonvulsants: Tegretol, Dilantin, Trileptal, phenobarbital
- Aptivus (tipranavir / ritonavir) yogwiritsidwa ntchito mu HIV mankhwala opatsirana pogonana
- Wotchedwa St. John's Wort
Kusamvana ndi kulingalira
Palibe zotsutsana za kugwiritsa ntchito Harvoni kwa odwala omwe ali ndi HCV genotype 1.
Komabe, kwa odwala omwe ali ndi kachilombo ka HIV pogwiritsa ntchito mankhwala a tenofovir (kuphatikizapo Viread, Truvada , Atripla, Complera, Stribild ), ayenera kuonetsetsa kuti akuyang'anitsitsa zotsatira zake, makamaka kuwonongeka kwa impso.
Mankhwala a antiacids ayenera kuthandizidwa mosiyana maola 4 asanayambe kapena pambuyo pa Harvoni mlingo, pamene mankhwala a proton pump inhibitors ndi H2 receptor inhibitors (aka H2 blockers) angafunike kuchepetsedwa kuti athetse kuchepa kwa ledipasvir.
Ngakhale kulibe kutsutsana kwa kugwiritsidwa ntchito kwa Harvoni pamene ali ndi mimba, deta yaing'ono yachipatala imapezeka. Komabe, maphunziro a nyama ku ntchito ya ledipasvir ndi sofosbuvir sanasonyeze mphamvu kwa kukula kwa fetus.
Kuyankhulana kwapadera kukulimbikitsidwa pa nthawi ya mimba kuti muwone kufunika kwa chithandizo cha Harvoni, makamaka ngati muyambe mwamsanga kapena kudikira mpaka mutatha kubereka.
Ndikoyenera kuti amayi onse omwe ali ndi zaka zakubadwa ayenera kuyang'aniridwa mwezi uliwonse kuti akhale ndi pakati pa nthawi ya mankhwala. Tilimbikitsanso kuti wodwala ndi mwamuna wake apereke njira ziwiri zosamalirako zogonana komanso kuti azigwiritsa ntchito panthawi ya mankhwala komanso kwa miyezi isanu ndi umodzi.
Chitsime:
US Food and Drug Administration (FDA). "FDA imavomereza mankhwala osokoneza bongo oyambirira kuti athe kuchiza matenda a hepatitis C." Silver Spring, Maryland; ndondomeko yofalitsa yomwe inatulutsidwa pa October 10, 2014.