Mankhwala osokoneza bongo , omwe agulitsidwa kwa mitundu yambiri ya kutupa nyamakazi kuyambira mu 1998, amathandizidwa ndi kulowetsedwa kapena kudzipiritsa . Zotsatira zoyipa, zomwe zingakhalepo ndi mankhwalawa, amatchulidwa ngati kulowetsedwa m'magazi kapena momwe amachitira ma sitelo. Zomveka zimawopa, sichoncho? Koma, muyenera kudziwa kuti zomwe zimachitika sizing'onozing'ono ndipo nthawi zambiri zimadutsa mosavuta.
Zowonongeka Kawirikawiri
Matenda omwe amagwirizana ndi kuchepetsedwa amatha kuphatikizapo kupwetekedwa mutu, kunyowa, urticaria (ming†™ oma), pruritus (kuyabwa), kuthamanga, kuthamanga, malungo, chills, tachycardia (kupweteka kwa mtima), ndi dyspnea (kuvutika kupuma).
Ngakhale kuti sizowoneka, zochita zambiri kapena anaphylactic zimachitika. Zikatero, kumangirira kwa chifuwa, bronchospasm, hypotension (kutsika kwa magazi), diaphoresis (kutuluka thukuta), kapena anaphylaxis (zomwe zimawopsa kwambiri kwa mapuloteni achilendo omwe amachokera pachiyambi). Ngati vuto lalikulu likuyamba, chithandizo cha biologic chiyenera kuimitsidwa mwamsanga ndi chithandizo chodzidzidzidwa. Nthaŵi zina, mankhwala oyamba asanakhale ndi acetaminophen, antihistamine, ndi corticosteroid yaifupi yokha ingathandize kupewa kulowetsedwa.
Malingana ndi olemba a Rheumatoid Arthritis: Chidziwitso Choyambirira ndi Chithandizo , chiwerengero cha mayesero a zachipatala chinawonetsa kuti pamene odwala pafupifupi 20 peresenti ochiritsidwa ndi Remicade (infliximab) anali ndi kulowetsedwa m'madzi, ocheperapo 1% mwa odwala a Remicade anachitapo kanthu kwambiri ndi 2.5 peresenti yokhayoketsa pakati pa odwala a Remicade omwe amachititsa kuti asiye kumwa mankhwalawa.
Kawirikawiri, zomwe zimaphatikizapo kulowetsedwa zimagwirizanitsidwa ndi Remicade zimachitika panthawi yopuma kapena mkati mwa maola awiri mutatha kukakamizidwa.
Tiyeni tikambirane zomwe zidziwitso zowonjezera za mankhwala osokoneza bongo zikuwululidwa, kukumbukira kuti mayesero osiyanasiyana a kuchipatala sangathe kufaniziridwa (mwachitsanzo, zotsatira za mayesero a Remicade sangathe kuziyerekezera ndi zotsatira zowonongeka chabe) ndipo deta yoyesedwa yachipatala singagwirizane ndi maulendo enieni enieni chitani.
- Simponi Aria: Pa nthawi yoyesedwa 1 (kupyolera pa sabata 24), 1.1% ya Simponi Aria infusions anali kugwirizana ndi kulowetsedwa poyerekeza ndi 0.2% ya infusions mu gulu lolamulira. Rash anali njira yowonjezera yotsekemera. Palibe zotsatira zowonongeka kwambiri zomwe zinafotokozedwa.
- Orencia (abatacept): Orencia amaphunzira III, IV, ndi V amavomereza kuti machitidwe okhudzidwa kwambiri a orencia anali ochiritsira poyerekeza ndi placebo (9% vs. 6% motsatira). Zochitika kawirikawiri zomwezo zinali chizungulire, kumutu, ndi hypotension (1-2%). Ochepa kuposa oposa 1% odwala Orencia adasiya kugwiritsa ntchito mankhwala chifukwa cha kusokonezeka kwakukulu. Anaphylaxis inachitika ochepera 0.1% mwa odwala omwe anachitidwa ndi Orencia.
- Actemra (tocilizumb): Phunziro lachidziwitso la masabata makumi awiri ndi awiri (24) lomwe linayang'aniridwa ndi odwala, kupweteka kwakukulu kunachitika pakati pa odwala 7-8%, malingana ndi mayesero awiri a Actemra omwe amagwiritsidwa ntchito, poyerekeza ndi 5% mu gulu la placebo. Chochitika chofala kwambiri panthawi ya kulowetsedwa anali kuthamanga kwambiri (1%). Zochitika kawirikawiri mkati mwa maola 24 a kulowetsedwa anali mutu (1%) ndi zotsatira za khungu (1%). Zochitika sizinachititse kuti asiye kusokonekera kapena kuchepetsa mankhwala.
- Rituxan (rituximab): Kulamulira kwa Rituxan kungabweretse mavuto aakulu, kuphatikizapo kuwonongeka kwa mankhwala opatsirana. Imfa mu maola 24 a Rituxan infusion yachitika. Pafupifupi 80% ya machitidwe okhudzidwa ndi kuikidwa m'magazi anachitika pokhudzana ndi kulowetsedwa koyamba.
Mu Rituxan RA anaphatikiza maphunziro opangira malobo, kutentha kwakukulu (malungo, kuzizira, kugunda, pruritus, urticaria kapena kutukumuka, angioedema, kupopera, kupweteka kwa khosi, chifuwa, kapena chifuwa cha bronchospasm, kapena osakhala ndi hypotension kapena hypertension). % a odwala a Rituxan akutsatira kulowetsedwa kwawo koyambirira, poyerekeza ndi 19% ya gulu la placebo. Zomwe zimachitika pakamwa kwachiwiri pambuyo pa kulowetsedwa kwa Rituxan kapena placebo zinachepetsedwa mpaka 9% ndi 11%, motero. Kusokoneza kwakukulu kwakukulu kunayambika ndi <1% mwa odwala mu gulu lonse la mankhwala.
Kusintha kwa mitsempha kunali kofunikira mu 10% mwa odwala odwala Rituxan poyerekeza ndi 2% a gulu la placebo.
Zoipa Zowonongeka Zowonongeka
Ndi mankhwala osokoneza bongo omwe amagwiritsidwa ntchito pang'onopang'ono, machitidwe a jekeseni amatha kuchitika koma kawirikawiri palibe mankhwala omwe amafunikira ndipo kusatayika kwa mankhwala sikofunikira.
Ochita kafukufuku ayang'ananso deta yoyesera zam'chipatala kuti awonetse kuchuluka kwa machitidwe a jekeseni. Ngakhale zimapereka lingaliro, kumbukirani, mayesero osiyana siyana a kuchipatala sangathe kufanikizidwa ndipo deta yoyesera zachipatala sizikutanthauza zomwe zimachitika kwenikweni.
- Enbrel (etanercept): M'mayesero olamuliridwa ndi malobo odwala matenda a rheumatologic, pafupifupi 37% a odwala omwe amachiritsidwa ndi Enbrel amapanga machitidwe a jekeseni. Machitidwe onse opatsirana pogwiritsa ntchito jekeseni amafotokozedwa kuti ndi ochepetsetsa (erythema, kuyabwa, kupweteka, kutupa, kutuluka magazi, kuvulaza) ndipo kawirikawiri sizinapangitse kusokoneza mankhwala. Zomwe zimachitika pa tsamba lajeremusi, makamaka masiku osachepera 3 mpaka 5, zimachitika m'mwezi woyamba ndipo kenako zinachepa pafupipafupi.
- Humira (adalimumab): Mu mayesero olamulidwa ndi malo, 20% odwala omwe amachitira Humira anayamba kupangika malo (jekeseni, kuyabwa, kutaya magazi, kupweteka kapena kutupa), poyerekeza ndi 14% mwa odwala omwe ali ndi malowa. Machitidwe ambiri opangira jekeseni amafotokozedwa ngati ofatsa ndipo kawirikawiri sankafuna kuti mankhwala asayambe.
- Kuwongolera (golimbumab): Mu mayesero omwe analamulidwa ndi Gawo lachiwiri / III, 3.4% a odwala okhawo anali ndi malingaliro a malo ojambulidwa poyerekeza ndi 1.5% mu gulu lolamulira. Zambiri mwazolowera ma sitelozo zinali zofatsa komanso zochepa, ndipo mawonetseredwe kawirikawiri anali erythema.
- Cimzia (certolizumab pegol): Panali kutchulidwa kuti angathe kutenga jekeseni malo omwe anachita ndi Cimzia muzofotokozera, zomwe sizinawathandize, koma palibe zambiri zomwe zinaperekedwa.
Zotsatira:
Matenda a Matenda a Khunyu: Matenda Oyamba ndi Kuzindikira. Kusi, Weinblatt, Kavanaugh. 2010. Kusintha kwachitatu. Mutharika, Inc.