Orencia (abatacept) inavomerezedwa ndi US Food and Drug Administration (FDA) pa Dec 23, 2005 monga mankhwala atsopano kuti athetse zizindikiro za matenda a nyamakazi . Orencia anaphatikizana ndi DMARD zina zitatu zowonongeka panthaŵi yochepetsanso kuwonongeka kwa zomangamanga, kuphatikizapo chotupa cha necrosis chotsutsana ndi mankhwala (anti-TNF mankhwala):
Simponi (golimumab) ndi Cimzia (certolizumab pegol), awiri owonjezera TNF, adavomerezedwa pambuyo pake.
Orencia amavomerezedwa modabwitsa kuti odwala matenda a nyamakazi akugwira ntchito mwamphamvu kwambiri omwe sakuyankhidwa mwachindunji kwa mankhwala osokoneza bongo (DMARDs) omwe kuphatikizapo antchito a TNF akuphatikizapo:
- Matendawa (methotrexate)
- Arava (kumbuyo)
- Plaquenil (hydroxychloroquine)
- Azulfidine (sulfasalazine)
Orencia Amayendetsedwa Bwanji
Mofananamo ndi Remicade (infliximab), Orencia amaperekedwa ngati kulowetsa m'mimba (IV). Orencia ngakhale amaperekedwa kwa mphindi 30, mosiyana ndi infliximab yomwe imayendetsedwa pafupi maola awiri.
Potsatira utsogoleri woyamba, Orencia amaperekedwa pa masabata awiri ndi 4, kenako masabata onse 4 pambuyo pake. Orencia angagwiritsidwe ntchito monga monotherapy (yekha) kapena mosagwirizana ndi ena a DMARD omwe si TNF antagonists chifukwa cha chiopsezo chowonjezereka cha poizoni ndi kuphatikiza.
Kuyambira mu Julayi 2011, chidziwitso chodzivulaza chokha cha Orencia chinavomerezedwa ndi FDA.
Zotsatira Zachisoni Zosakanikirana ndi Orencia
Zotsatira zoyipa zimaphatikizapo koma sizingatheke ku:
- zovuta zomwe zimachitika kawirikawiri zingakhale zowopsya
- matenda
- Matenda a kupuma (makamaka odwala omwe ali ndi matenda osokoneza bongo omwe amachititsa kuti matendawa asapitirire)
Mfundo Zomwe Mungaganizire Musanayese Orencia
Mtengo wa Orencia kuphatikizapo kuwunikira kwawo ndiwowonjezera kuposa odwala omwe ali ndi TNF oyambitsa jekeseni adalimumab ndi etanercept koma osakwana infliximab. Orencia wasonyeza phindu lochepa pokhapokha atagwiritsidwa ntchito payekha kotero kuti ndi bwino kuperekedwa ndi DMARD ina monga methotrexate kapena ena kuti akwaniritse zotsatira zabwino.
Mpaka pali zochitika zambiri zachipatala ndi Orencia, madokotala ena amawasungira iwo odwala omwe alephera awiri mwa atatu omwe ali ndi TNF antagonists (akuyesa ndi zotsatira zovuta kapena zopanda phindu). Mankhwalawa amapezeka pamsika popeza atanercept adayambitsidwa mu 1999 ndipo amasonyeza kuti phindu la phindu lopindulitsa.
Orencia vs. Anakinra
Anakinra kawirikawiri amagwiritsidwa ntchito pochiza nyamakazi chifukwa cha kufunika kwa jekeseni tsiku ndi tsiku poyerekeza ndi antchito a TNF omwe amalepheretsa ntchito ya TNF (cytokine kapena mtumiki pakati pa maselo). TNF ndi kagawo kamene kamakhala ndi mbali yaikulu pakuchititsa kutupa ndi kuwonongeka mu nyamakazi ya nyamakazi.
Maselo a T amathandizanso kuwonetsa zizindikiro za matenda a nyamakazi. Orencia amaletsa chizindikiro m'magazi chomwe chili chofunikira kuti maselo a T awonongeke.
Kineret (anakinra) imatsegula ILtokine ya cytokine yomwe imathandizira kuwonongeka kwa fupa lomwe liri gawo la nyamakazi ya nyamakazi.
Yankho loperekedwa ndi Scott J. Zashin, MD, pulofesa wothandizira wathandi ku University of Texas Southwestern Medical School, Division of Rheumatology, ku Dallas, Texas. Dr. Zashin nayenso akupita kuchipatala ku chipatala cha Presbyterian ku Dallas ndi Plano. Iye ndi mnzanga wa American College of Physicians ndi American College of Rheumatology ndi membala wa American Medical Association.