Ukwahlukana Kwekhiye Ku-Efficacy, Izindleko, Nokuphatha
I-TNF inhibitors (eyaziwa nangokuthi i-TNF blockers) yilasilasi lemithi eyanciphisa ukuvuvukala ngokushisa ukuphendula komzimba. Zisetshenziselwa ukwelapha izifo ezihlukahlukene ezizimele ezibandakanya i- rhumatoid arthritis (RA) , i-psoriasis, i-psoriatic arthritis, i-ulcerative colitis, nesifo sika-Crohn.
I-inhibitors ye-TNF ethandwa kakhulu ekusetshenziselwa ukwelapha i-RA yilezi:
- Enbrel (etanercept)
- Huma (adalimumab)
- I-Remicade (i-infliximab)
Nakuba zonke izidakamizwa ezintathu zivimbela impendulo yomzimba ngesifo se-necrosis factor (TNF) -ahlobo lweprotheyini, okuthiwa i- cytokine . okuyinto eyenza ukuvuvukala-ngayinye isakhiwo semikhiqizo ehlukene kanye nezinzuzo ezithile kanye nokulinganiselwa.
Indlela i-TNF Inhibitors esebenza ngayo
I-TNF inhibitors yimihlobo yezidakamizwa ze- biologic esetshenziselwa ukuphatha izifo ezizimele njenge-RA. Ngenkathi zihlose ngqo i-TNF, ezinye ze-cytokines ezihlose i-cytokines njenge-interleukin noma zishintsha indlela amaseli omzimba omzimba (abizwa ngokuthi ama-T-cells noma ama-B-cells) asebenza ngayo.
I-TNF inhibitors iye yaba amathuluzi abaluleke kakhulu ekuphathweni nasekwelapheni i-RA kusukela ekusungulweni kwayo ngo-1998. Isebenza kahle ezingxenyeni ezingaphezu kuka-70 zabantu abaphila nesifo, kuhlanganise nalabo abangazange basabele emtholampilo wokuqala we-methotrexate.
Uma isetshenziselwa ukuhlanganiswa ne-methotrexate, i-TNF inhibitors iyaziwa ukuthi iyasebenza nakakhulu ekubuyiseni izinga lempilo yabantu abagulayo, ngokuvamile ngamaviki angu-12.
Umehluko kokuPhatha
Ngenkathi isenzo senzosi esingafani kakhulu kuzo zonke izidakamizwa ezintathu, i-Enbrel, i-Humira, ne-Remicade inezinombolo ezimbalwa ezihlukile. Omkhulu phakathi kwabo ukuphathwa kwezidakamizwa kanye nokuvama kokulandelwa.
Ngenkathi kube khona ukuhlukahluka kokuthi izidakamizwa zisetshenziselwa kanjani, ngokuvamile zichazwe kanje:
- I-enbrel inikezwa nge- injection encane (esikhumbeni) kanye noma kabili ngesonto.
- U-Humira unikezwa umjovo ongaphansi kwesinye isonto.
- I-Remicade idinga ukumnika okufakwe emangcwabeni njalo ngemva kwamasonto amane kuya kwangu-8.
Ngaphezu kwalokho, ngokungafani ne-Remicade, i-Enbrel ne-Humira ingaba yilawulwa yi-dosage-elawulwayo. ipeni elijoqayo (njengalezo ezisetshenziswa abantu abanesifo sikashukela ukuze bajobe i-insulin).
Umehluko ku-Efficacy
Enye indlela izidakamizwa ezihluke ngazo ngayo ubude obuphakathi bokusebenza, okusho isikhathi esingakanani ongayisebenzisa ngaphambi kokuba udinga ukushintsha ukwelashwa.
Ngalokhu, ukuziphatha kokufunda ngo-2013 ososayensi e-University of Valladolid eSpain kuphenye ukwelashwa okujwayelekile kwe-Enbrel, i-Humira, ne-Remicade kubantu abangu-91 abane-RA.
Lokho abathola ukuthi kokubili u-Enbrel noHuma babenesikhathi sokusebenza okungaphezu kweminyaka eyisikhombisa (izinsuku ezingu-2,561 nezinsuku ezingu-2,769, ngokulandelana). Uma kuqhathaniswa, uRicicade wayenesikhathi sokwelapha isilinganiso seminyaka engaphezu kwenguhlanu (izinsuku ezingu-1 853).
Kulezi zidakamizwa ezintathu, i-Enbrel yabonisa isikhathi esiphezulu sokusebenza kahle, ikakhulukazi kwabesifazane abahlala emithini yokwelapha cishe iminyaka eyisishiyagalolunye (izinsuku ezingu-3 191). Ngaphezu kwalokho, abantu asebekhulile e-Enbrel babengeke bakwazi ukushintsha kwenye i-TNF biologic.
Nakuba iziphetho zilinganiselwe ngesilinganiso socwaningi, abacwaningi baphetha ngokuthi, kulabo abathathu be-TNF inhibitors, i-Enbrel yabonisa ukuphakama okucacile.
Ukungafani Kwezindleko
I-TNF inhibitors konke kubiza kakhulu uma kuqhathaniswa nezinye izidakamizwa ze-RA, inkinga yayo efanelekile ekwelapheni kwakho.
Nakuba ukutholakala kwezidakamizwa kungase kuthuthukiswe ngemuva kokufaka imali emakhokheni e-co-payments, izaphulelo zokuthengisa, kanye nezinhlelo zokusizwa ngesineke, ungalindela ukuthi inani eliphelele lizowela ngaphansi kwezigaba:
- I-Huma imali ephakathi kuka-$ 1,800 no-$ 2,400 ngenyanga.
- Izibungu ze-Enbrel ezingaphezu kwe-$ 4,000 ngenyanga.
- Isilinganiso esisodwa se-Remicade singabiza noma yikuphi kusuka ku-$ 1,250 kuya ku-$ 2,500, kuye ngokuthi udinga ukudubula njalo emavikini amane noma amasonto ayisishiyagalombili.
Nge-Remicade, kubalulekile futhi ukubheka izindleko zokungenwa esibhedlela. Ngokuphambene nalokho, u-Enbrel no-Humira ngeke babe nalezi zindleko uma unquma ukuzijoba.
Ekugcineni, izindleko zokwelashwa kweqiniso zizoxhomeka ekubhaliseni umshuwalense wakho kanye nokufaneleka kwakho kosizo lokukhokha ngokuhlanganyela njengoba kunikezwa abakhiqizi be-Enbrel, i-Humira, ne-Remicade.
> Umthombo:
> Martinez-Santana, V ,; I-Gonzalez-Sarmiento, E .; Calleja-Hernandez, M. et al. "Ukuqhathaniswa kwamazinga okusinda kwezidakamizwa ngenxa ye-tumor necrosis ephikisanayo ne-arthritis ye-rheumatoid." Isiguli sithande ukuvumelana . 2013; 7: 719-27. I-DOI: 10.2147 / PPA.S47453.