Ubukeka Njengalo - Kodwa Imibuzo Hlala
Isihloko esivela eNew England Journal of Medicine ngasekupheleni kuka-Agasti, 2014 sikhombise ukuthi kungenzeka ukuphumelela okusha ekwelapheni kwehluleka kwenhliziyo . Lesi sihloko sichaza imiphumela evela ku-PARADIGM-HF isifundo, lapho iziguli ezinokuhluleka kwenhliziyo zithathwa ngezidakamizwa zokuphenya ngeveli. Isidakamizwa, esakhiwe yi-Novartis, sintsha kangangokuthi asizange sabizwe ngisho namanje - okwamanje kuthiwa yi-LCZ696.
I-LCZ696 empeleni iqukethe izidakamizwa ezimbili ezihlanganisiwe ndawonye - i-valsartan (okuyinto i-ARB inhibitor esetshenziswa kakhulu) kanye ne-agent entsha, i-sacubitril. I-Sacubitril isebenza ngokuvimbela i- enzyme neprilysin , futhi ngenxa yalokho amazinga wegazi we-peptide ama-natriuretic akhula. Ngenxa yokuthi ama-peptides we-natriuretic angaba nenzuzo ekuhlulekeni kwenhliziyo, abacwaningi basho ukuthi i-LCZ696 ingathuthukisa umphumela weziguli ezile nkinga. Imiphumela yocwaningo lwe-PARADIGM-HF lisikisela ukuthi abacwaningi babelungile.
Kulesi sifundo, iziguli ezingaphezu kwezingu-8000 ezinokuhluleka kwenhliziyo zazingenakulinganiswa ukuthola i-LCZ696, noma ukwelashwa okujwayelekile usebenzisa i-enalapril ye- ACE inhibitor . Ezigulini ezithatha i-LCZ696, emva kwezinyanga ezingu-27 ingozi yokwelashwa kwenhliziyo yehluleka futhi ingozi yokufa yomibili yanciphisa cishe ngo-20%. Leli phuzu lokuthuthukiswa, phezu kwalokho okwamanje okubhekwa njengokwelashwa okuhle kwenhlupho yenhliziyo, kuyamangalisa ngempela.
Okwenza Lesi sifundo sibaluleke
Imiphumela ye-PARADIGM-HF ibalulekile okungenani izizathu ezimbili. Okokuqala, kuphakamisa ukuthi isidakamizwa esisha se-LCZ696 kufanele sinikeze ithemba elisha ngeziguli eziningi ezinesifo senhliziyo - uma kuvunyelwe ukusetshenziswa ngu-FDA.
Futhi okwesibili, lolu cwaningo luvula indlela entsha yokuphatha ukuhluleka kwenhliziyo.
Ngakho-ke, singalindela izidakamizwa ezengeziwe ukuthi zithuthukiswe, njengeLCZ696, zivimbela i-enzyme neprilysin.
Ngabe LCZ696 Izokwenziwa nini?
Isidakamizwa esisha asikwazi ukumiswa kuze sidlule ukubuyekezwa okunamandla yi-FDA. Njengoba ucabanga ukuthi konke kuhamba kahle ngalesi sibuyekezo, okokuqala esingalindela ukuthi izidakamizwa zivunyelwe ukusetshenziswa kuzoba yisikhathi ngo-2015.
Zikhona Izingozi Ezingaba Khona NoLCZ696?
Okwamanje, ilanga le-PARADIGM-HF ligujwa njengendlela entsha yokuphatha ukwelashwa kwenhliziyo. Futhi sonke sithemba ukuthi kuzoba yilokho. Kodwa-ke, kukhona okungenani izizathu ezintathu zokuthi sibe nomdlandla wethu okwamanje.
Okokuqala, "ukuqhuma okusha" kumenyezelwa njalo emva kokuhlolwa kwemithi ngemithi emisha. Futhi ngenkathi ngezinye izikhathi kuvela ukuthi ukuphumelela kwangempela kwenzeke ngempela, ngokuvamile kwenzeka ukuthi ukwelashwa okusha kunganikeza ngaphezulu inzuzo engaphansi, futhi kungase kungabi khona impumelelo, kunokuba ivele kuqala.
Okwesibili, eminyakeni engaphezu kweyishumi eyedlule umuthi obizwa ngokuthi i-nesiritide (Natrecor) nawo wenziwa njengendlela yokwelashwa kwenhliziyo. Lokhu kuyadingeka ngoba i-nesiritide ayizange ikhulise ngokungaqondile amazinga ama-peptide angama-natural as LCZ696 enza; i-nesiritide yayiyi -peptide ye-natriuretic.
Kuthatha iminyaka eminingana, kanye nokuhlolwa okungaphezulu kwemitholampilo, ukukhombisa ukuthi i-nesiritide empeleni yayinzuzo kuphela (uma ikhona) ekwelapheni ukuhluleka kwenhliziyo. Lo mlando mhlawumbe kufanele ufuthe kancane intshiseko manje echazwe ngo-LCZ696.
Okwesithathu. . .
I-Neprilysin inemisebenzi eminingana ngaphezu kokunciphisa amazinga ama-peptide angama-natriuretic, kanti enye yale misebenzi inenzuzo. Ngokuyinhloko, i-neprilysin ingasiza ekuvimbeleni izifo ezithile ezihlobene nokuqoqwa kwamaprotheni angathandeki emzimbeni, njengesifo se-Alzheimer kanye ne- amyloidosis , ngisho nomdlavuza wesicathulo . Ngakho-ke ukuvimbela i-neprilysin kungase kungabi yinto enhle yonke yokuyenza.
Ungafunda kabanzi ngale nkinga engenzeka lapha.
- Nasi isibuyekezo ku-LCZ696 (manje esibizwa nge-Entresto), esamukelwe yi-FDA ngoJulayi, 2015.
Imithombo:
McMurray JJV, Packer M, Desai AS, et al. Ukuvinjelwa kwe-Angiotensin-neprilysin ngokuhambisana ne-enalapril ekuhlulekeni kwenhliziyo. N Engl J Med 2014; I-DOI: 10.156 / NEJMoa1409077.
Jessup M. Neprilysin ukuvimbela-itravel novel yokuhluleka kwenhliziyo. N Engl J Med 2014; I-DOI: 10.1056 / NEJMe1409898.
Nalivaeva NN, Belyaev ND, IA Zhuravin, IA, et al. I-Peptidase i-Alzheimer's Amyloid-Degrading, i-Neprilysin: Ingabe Singayilawula? I-International Journal ye-Alzheimer's Disease's Volume 2012 (2012), i-Article ID 383796. Itholakala ku-: http://dx.doi.org/10.1155/2012/383796 (kufinyelelwe ngo-9/2/2014).