Mankhwala Osokoneza Bongo Amapereka Mpata Waukulu wa Matenda a Genotype 1 ndi 4 Matenda
Kulemba
Zafati (elbasvir / grazoprevir) ndi mankhwala osakaniza omwe amagwiritsidwa ntchito pochiza matenda aakulu a chiwindi cha hepatitis C (HCV) . Mankhwala awiri omwe amaphatikizapo ntchito Zepatier (elbasvir, grazoprevir) potseka onse mapuloteni (NS5a) ndi enzyme (NS3 / 4a protease) ndi ofunikira kuti kachilombo ka HIV kamveke.
Zepatier inavomerezedwa pa January 28, 2016 ndi US Food and Drug Administration (FDA) kuti agwiritsidwe ntchito kwa anthu akuluakulu zaka 18 kapena kupitilira ndi matenda a HCV 1 kapena 4 , kuphatikizapo odwala matenda a chiwindi.
Amavomerezedwa kuti agwiritsidwe ntchito onse osatetezedwa (odwala-naïve) kapena odwala omwe kale anachiritsidwa (odwala) omwe amachiritsidwa, malinga ndi ma HCV genotype ndi momwe amachitira mankhwala.
Zogwira mtima
Zefatier akuti ali ndi mankhwala ochiritsira ochiritsira m'mayesero a anthu a Phase II. Thandizo la HCV limatanthawuza kuti limakhala ndi mphamvu yosawerengeka ya mavenda kwa masabata makumi awiri (24) pakatha kutsirizidwa kwa mankhwala (omwe amadziwikanso kuti mavirologic response, kapena SVR ).
Ndalama zonse za SVR zinachokera ku 94% mpaka 97% mwa odwala matenda a HCV genotype 1, pamene odwala matenda a genotype 4 anauzidwa kukhala ndi SVR chiwerengero cha 97% mpaka 100%.
Mlingo
Pulogalamu imodzi (50mg / 100mg) imatengedwa tsiku ndi tsiku kapena popanda chakudya. Mapiritsi a zofiira ali oboola, oboola ndi mafilimu, okhala ndi "770" omwe ali pambali imodzi.
Kulemba Malangizo
Zopatsa chilolezo chimayikidwa kapena popanda ribavirin kwa genotype 1 kapena 4 matenda. Mosiyana ndi zachipatala za HCV zam'mbuyo, peginterferon (mankhwala osokonezeka omwe nthawi zambiri sungatheke) sakufunika.
Musanayambe kulandira mankhwala, kuyezetsa kwa majini kungathandize kuti mudziwe ngati muli ndi kachilombo kamene kamagonjetsedwa ndi mbali ya elbasvir ya Zepatier (yotchedwa NS5a yotsutsana ndi polymorphism).
Nthawi ya mapaipi a mankhwala kuyambira masabata 12-16, malinga ndi ma HCV genotype ndi malo ochizira.
| Genotype | Chikhalidwe cha mankhwala | Kutengedwa ndi ribavirin? | Nthawi |
| Genotype 1a | mankhwala-naïve popanda elbasvir-osagwira HIV | ayi | Masabata 12 |
| mankhwala-naïve ndi elbasvir osagonjetsedwa HIV | inde | Masabata 16 | |
| kale ankachitidwa ndi ribavirin + peginterferon opanda virusi chosakanikirana ndi elbasvir | ayi | Masabata 12 | |
| kale ankachitidwa ndi ribavirin + peginterferon ndi kachilombo kosagonjetsedwa ndi elbasvir | inde | Masabata 16 | |
| kale ankachitidwa ndi ribavirin + peginterferon + HCV protease inhibitor | inde | Masabata 12 | |
| Genotype 1b | mankhwala-naïve | ayi | Masabata 12 |
| kale ankachitidwa ndi ribavirin + peginterferon | ayi | Masabata 12 | |
| kale ankachitidwa ndi ribavirin + peginterferon + HCV protease inhibitor * | inde | Masabata 12 | |
| Genotype 4 | mankhwala-naïve | ayi | Masabata 12 |
| kale ankachitidwa ndi ribavirin + peginterferon | inde | Masabata 16 |
* - Olysio (simeprevir), Victrelis (boceprevir), Incivek (telaprevir)
Zotsatira Zogwirizana
Zotsatira zambiri zomwe zimagwirizanitsidwa ndi kugwiritsidwa ntchito pafupipafupi (kumachitika odwala oposa 5%) ndi:
- Kutopa
- Mutu
- Nausea
Pogwiritsidwa ntchito ndi ribavirin, mankhwala omwe amawopsa kwambiri (omwe amapezeka oposa 5%) amagwiritsa ntchito:
- Mutu
- Kutopa
- Anemia
- Nausea
- Kutentha
- Kudzikuza
- Kupuma pang'ono
- Kusagona
- Kupweteka kwa minofu
- Kuchepetsa kudya
- Kukuda
- Kukhumudwa
- Rash
Kuyanjana kwa Mankhwala
Mankhwala otsatirawa sayenera kugwiritsidwa ntchito pamene atenga Zapakati chifukwa angayambitse kuyankhulana kwa mankhwala osokoneza bongo:
- Maantibayotiki: nafcillin
- Anticonvulsives: Dilantin (phenytoin), Tegretol (carbamazepine)
- Antifungals: Ndizoral mapiritsi (ketoconazole)
- Mankhwala osokoneza bongo: Tracleer (bosentan)
- Zitsamba zam'madzi: St. John's Wort
- Matenda ochepetsa kachirombo ka HIV: Aptivus (tipranavir), Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide), Intelence (etravirine), Invirase (saquinavir), Kaletra (lopinavir, ritonavir), Prezista (darunavir), Reyataz (atazanvir), Stribild ( elvitegravir, cobicistat, emtricitabine, osagwirizana ndi tenofovir), Sustiva (efavirenz),
- Mankhwala osokoneza bongo amagwiritsidwa ntchito popewera kukana kugwiritsidwa ntchito: cyclosporine
- Mankhwala opangira Rifampin omwe amagwiritsidwa ntchito pochiza chifuwa chachikulu: Mycobutin, Priftin, Rifater, Rifamate, Rimactane, Rifadin
Zotsatira za Chithandizo
Zakhala zikufotokozedwa m'maphunziro a zachipatala omwe odwala 1% odwala Zepatier anayamba kukula kwambiri kwa mavitamini a chiwindi omwe amasonyeza chiwindi cha chiwindi, makamaka pa sabata lachisanu ndi chitatu la mankhwala. Momwemo, kuyesedwa kwa magazi ndi chiwindi chiyenera kuchitidwa musanayambe kulandira chithandizo komanso nthawi zonse pa mankhwala a HCV.
Zoperewera sayenera kuuzidwa kwa odwala omwe ali ndi vuto lalikulu la chiwindi.
Kugwiritsiridwa ntchito kwa ribavirin kumatsutsana pa mimba ndipo sayenera kulamulidwa ndi Zepatier kapena mankhwala ena amtundu wa chiwindi. Odwala achikazi omwe ali ndi chithandizo cha ribavirin ayenera kulangizidwa kuti asatenge mimba komanso kuti asagwiritse ntchito njira ziwiri zosamalirako panthawi ya mankhwala komanso kwa miyezi isanu ndi umodzi mutatha mankhwala.
Chitsime:
US Food and Drug Administration (FDA). "FDA imavomereza Zepatier kuti yodwala matenda odwala matenda a chiwindi a mtundu wa 1 ndi 4 akudwala." Silver Spring, Maryland; ndondomeko yomasulira yomwe inatulutsidwa pa January 28, 2016.
Merck "Zapatier - Mfundo Zofunika Kufotokozera." Kenilworth, New Jersey; inapezeka pa January 29, 2016.