I-Rheumatoid Arthritis Isiguli Esifundweni seRituxan Isifundo Sakha Isihloko Esibulalayo se-PML
Icala elibulalayo le-PML (i-multifocal leukoencephalopathy) eliye laqhubeka liye labonwa esigulini se- rheumatoid arthritis (RA) esibambe iqhaza esilweni sokwelulwa kokuphepha emtholampilo ye- Rituxan (rituximab). Ngenxa yalokho, i-FDA nomkhiqizi wezidakamizwa uye wakhipha isixwayiso futhi uzobuyekeza i-Rituxan enquma ulwazi lokufaka i-PML.
Kuyini i-PML?
I-PML yaziwa nangokuthi i-leukoencephalopathy ye-multifocal eqhubekayo.
Ngokusho kweNational Institute of Neurological Disorders and Stroke, "I-progressive multifocal leukoencephalopathy (PML) ibangelwa ukuvuselelwa kwegciwane elivamile ohlelweni lwezinzwa oluphakathi kwabantu abathinteka ngokuzivikela. I-Polyomavirus JC (evame ukubizwa ngokuthi i-JC virus) ithathwa yi- iningi labantu futhi alilimazi ngaphandle kwalabo abanesisindo sokuzivikela sokuzivikela. "
Uyaziwa Kakhulu Nge-RA Umguli Othuthukile I-PML?
Isiguli se-RA saqale saqala ukutheleleka ngegciwane le-JC bese i-PML. Ukufa kwe-PML kwenzeka ngemuva kwezinyanga ezingu-18 ngemuva kokuba isiguli sithole umthamo wokugcina weRituxan esifundweni sokwandisa ukuphepha.
Isiguli se-RA sasikhulekele umdlavuza we-oropharyngeal (umdlavuza womphimbo ) futhi waphathwa nge-chemotherapy nezinyanga ezingu-9 ngaphambi kokuthuthukisa i-PML. Isiguli sasinomlando wezokwelapha obunzima kakhulu owakwazi ukusiza ekuthuthukiseni i-PML. Ngaphandle kwe-RA, isiguli sinesifo se- Sjogren sika futhi singabonakali sisekela amazinga we-C4.
Isiguli sasiphathwa nge-methotrexate, steroids, kanye ne-TNF blocker ngaphambi kokuphathwa nge-Rituxan. I-Methotrexate ne-steroid nayo isetshenziselwa ukwelashwa ngesikhatsi nangemva kwe-rituximab.
Iyini i-FDA eyenzayo ekuphenduleni inkinga ye-PML?
I-FDA iphinda ibuye ibuye imise imiyalelo futhi ikwazise ochwepheshe bezezempilo encwadini nasemphakathini kuwebhusayithi yayo mayelana necala elibulalayo le-PML.
Yini Okufanele I-RA Iziguli Ziphathwe Nge-Rituxan Do?
Ngokuvamile, xoxani nodokotela wakho ngezinto ozikhathazayo. Ochwepheshe bayeluleka ukuthi uma isiguli esiphathwe ngeRituxan senza izimpawu ze-neurologic - ukubonisana nomuntu wezinzwa, ubuchopho be-MRI, nokukhishwa kwe-lumbar kufanele kucatshangelwe. Iziguli ezakha i-PML kufanele ziyeke i-Rituxan, kungenzeka ziyeke noma zinciphise ezinye izifo zokuzivikela, kuyilapho zicubungula ukwelashwa okulwa negciwane. Kodwa, akukho ngempela ukwelashwa okungaxazulula i-PML uma iqala.
Imithombo:
I-FDA: Icala elibulalayo le-Progressive Multifocal Leukoencephalopathy kuMguli Othola I-Rituximab. Izindaba Zomhlahlandlela WeDokotela . Ngo-September 11, 2008.
I-FDA Medwatch. Ulwazi olubalulekile lokuphepha olumayelana neLeukoencephalopathy ye-multifocal eqhubekayo nokusetshenziswa kweRituxan. Ngo-September 11, 2008.