Kanye Ukwelapha Okuvamile kwe-Rheumatoid Arthritis
Esikhathini esedlule, ukwelashwa kwegolide kwakuyindlela yokwelashwa ejwayelekile ngokulinganisela ukuze usebenze ngokuqinile. I-Gold compounds yayisetshenziselwa ukwelapha i-rheumatoid arthritis kusukela ngo-1929. Igolide langempela lathuthukiswa njengelashwa ngesifo sofuba. Ngaleso sikhathi, ngokungafanele ngacabanga ukuthi isifo sofuba nesifo se-rheumatoid sezihlobene nezimo. Nakuba lokho kungabonakali, igolide yaveza umphumela omuhle ku-arthritis ye-rheumatoid.
Indlela Esebenza ngayo
Nakuba indlela ye-anti-inflammatory yegolide engacaciswanga ngokugcwele, ubufakazi bubonisa ukuthi igolide igcinwa kuma-lysosomes okuvimbela ukusetshenziselwa ama-antigenic (nanoma iyiphi into evuselela ukukhiqizwa kwama-antibodies) nokukhululwa kwama- cytokines angenawo amandla. Ngakho-ke kuthiwa yi -drug-modifying anti-rheumatic drug (DMARD) .
Ukutholakala kweGold
Izinhlobo zama-parenteral zegolide zijojowe futhi zifaka i-Myoschrysine (aurothiomalate) ne-Solganol (i-aurothioglucose). I-Ridaura (i-auranofin) iyindlela yokwelapha yegolide ngomlomo. Eminyakeni edlule, njengoba kunesifo esisha esitholakalayo esanikeza inzuzo ephakeme kanye nengozi encane (isb., Ezinye izidakamizwa ze-DMARD kanye nezidakamizwa ze-biologic ), ukujova kwegolide kwakungavamile ukuba kwenziwe isifo samathambo. Ukusetshenziswa kwalo kunciphise ikakhulukazi ngenxa yengozi yemiphumela emibi, kanye nesidingo sokuqapha okuqhamuka emtholampilo kanye nelabhoratri, kanye nokuphazamiseka komjovo we-intramuscular.
I-Gold iphathwa kanjani?
Izibhamu zegolide zenziwa njengemjovo ye-intramuscular ehhovisi likadokotela masonto onke ngamaviki angu-20 okuqala ukwelashwa bese kuthi umvuthwandaba uphethwe njalo emavikini amathathu noma amane. Ukuhlolwa kwegazi kanye nokuhlolwa komchamo kunconywa ngaphambi komjovo wegolide ngamunye, ukuqinisekisa ukuthi kuphephile ukunikeza.
Ekuqaleni, umjovo wegolide we-intramuscular ngokuvamile uhlinzekwa njengendlela encane 10-milligram umthamo, kanye ngesonto. Isilinganiso sesibili sama-25-milligram silandela bese kuthi ama-milligram ama-50 ngesonto kuze kube yilapho impendulo ifinyelelwa, kuze kube ngu-750 kuya ku-1000 milligram.
Imiphumela emibi Yenza Ukwelapha Kwegolide Kuyinselele
Imiphumela emibi, isizathu esivame kakhulu sokuyeka ukuguqulwa kwegolide, kuthinta cishe amaphesenti angu-30 abantu abaphathwa ngezakhi zegolide ezindala. Imiphumela emibi kakhulu ehambisana negolide eliphakathi kwamagama ihlanganisa i-pruritis, i-dermatitis, i-stomatitis, ne-proteinuria. Ngegolide lomlomo, izitshalo ezivulekile ziwumphumela ovamile ohlangothini olulodwa, kanti uhudo lwamanzi lwenzeka kancane kancane (oluthinta amaphesenti angu-5 weziguli). I-Nephropathy ne-thrombocytopenia ingahle ibe ne-therapy yegolide, ikakhulukazi kulabo abahle kwi-gene HLA-DR3.
Ngenkathi imiphumela emibi ingase ibe yinkinga ye-therapy yegolide, kufanele kuqaphele ukuthi izijovo zegolide zabeka abanye abantu abane-arthritis ye-rhumum in remission engunaphakade. Isazi se-Rheumatologist uScott J. Zashin, uM MD wathi, "Ngenxa yalokho, uma isiguli sithole impendulo enhle kwizijovo zegolide, zivame ukuqhubeka. Ukubeka igolide kulezi ziguli kungabangela ukuphindaphindiwe komsebenzi we-arthritis okungase ungaphenduli ukuvuselelwa kokwelapha ngegolide. "
Kodwa-ke, njengoba amahlumela egolide asebenzisa kancane futhi njengoba kwakhiwa izinyathelo ezintsha, izinkampani ziyeka ukwenza imithi. Ngenkathi kwakunezinhlobo ezimbili ze-shots zegolide ngesikhathi esisodwa (i-Solganol ne-Myochrysine), i-Myochrysine kuphela manje itholakala. Ngokuvamile, iziguli zithuthukisa ukusabela kuyo, okwenza kube khona ukuyeka ukuyeka.
I-Oral Gold Iqhathaniswa neGold Injectable
Ngeshwa, igolide lomlomo laveza kuphela imiphumela emihle kakhulu, ngakho-ke kwakunqunyiwe ngokungavamile. I-Ridaura, ukulungiswa kwegolide ngomlomo, kungenzeka isatholakala, kodwa ayivame ukusetshenziswa e-United States. Igolide le-Oral iboniswe ukuthi iphumelele ngokulinganisela uma iqhathaniswa ne-placebo.
Kwakubhekwa njengokusebenza ngokulinganayo ku- Plaquenil (i-hydroxychloroquine) ne- methotrexate , kodwa kunakho konke okusemandleni okulwa nobuthi.
Okubalulekile
Igolide i-DMARD endala (izidakamizwa zokuguqula izifo ezithathelwanayo nezifo), cishe cishe zonke izimo, zithathwe yi-DMARD entsha kanye nezidakamizwa ze-biologic. Ukusetshenziswa kwegolide kugcinwe iziguli ezingaphenduli noma ezingenakubekezelela imettretrexate, namanye ama-DMARD amadala (njenge-Plaquenil ne- sulfasalazine ), noma ama- block block ye-TNF .
Imithombo:
> Cush JJ, Weinblatt ME, i-Kavanaugh A. I-arthritis ye-Rheumatoid: ukuxilongwa kokuqala kanye nokwelashwa . West Islip, NY: Ukuxhumana kobuchwepheshe; 2010.
> Klinkhoff A. Amandla emibi kakhulu wezokwelapha zegolide. Kusesikhathini. https://www.uptodate.com/contents/major-side-effects-of-gold-therapy.
> Klinkhoff A. Ukusetshenziswa kweMigomo Yegolide e-Rheumatic Diseases. Kusesikhathini. https://www.uptodate.com/contents/use-of-gold-compounds-in-rheumatic-diseases?source=see_link.