Imithi yokwelapha inikeza amazinga aphezulu okuphulukisa ama-Gyropepe 1 and 4 Infections
Ukuhlukaniswa
I-Zepatier (elbasvir / grazoprevir) isisindo esinqunyiwe sokuhlanganiswa kwezidakamizwa esetshenziswa ekwelapheni ukutheleleka okungapheli kwe- hepatitis C (HCV) . Lezi zidakamizwa ezimbili ezibandakanya umsebenzi we-Zepatier (elbasvir, grazoprevir) ngokuvimbela kokubili amaprotheni (NS5a) ne-enzyme (NS3 / 4a protease) ibalulekile ekuphindaphindiwe kwegciwane.
I-Zepatier yamukelwa ngoJanuwari 28, 2016 yi-US Food and Drug Administration (FDA) ukuze isetshenziswe kubantu abadala kweminyaka engu-18 noma ngaphezulu nge- HCV genotype 1 noma 4 ukutheleleka , kufaka nalabo abane-cirrhosis.
Kuvunyelwe ukusetshenziswa kokubili okungaphathwa kabi (ukwelashwa-naïve) noma iziguli ezilashwa ngaphambili (iziguli ezithintekayo), ngokuya nge-genotype ye-HCV kanye nesimo sokwelapha.
Ukusebenza
I-Zepatier ibikwa ukuthi inezibalo eziphuthumayo zokwelashwa eSigabeni II sokuhlolwa kwabantu. Ukuphulukiswa kwe-HCV kuchazwa njengokulondoloza umthamo wegciwane elingenakulinganiswa kwamasonto angu-24 ngemva kokuphela kwelashwa (eyaziwa ngokuthi impendulo ye-virologic eqhubekayo, noma i-SVR ).
Izinga le-SVR jikelele lalingu-94% kuya ku-97% ezigulini ezine-HCV genotype 1 ukutheleleka, kanti iziguli ezine-genotype 4 zibhekwe ukuthi zinezibalo ze-SVR zika-97% kuya ku-100%.
Isilinganiso
Ithebhulethi eyodwa (50mg / 100mg) ithathwe nsuku zonke noma ngaphandle kokudla. Amaphilisi e-Zepatier ane-oval-shaped, beige-colored nefilimu-enemibala, ene "770" embossed ngakolunye uhlangothi.
Ukubeka izincomo
I-Zepatier inqunywe noma ngaphandle kwe-ribavirin ye-genotype 1 noma 4 ukutheleleka. Ngokungafani nemithi yokwelapha ye-HCV eyedlule, i- peginterferon (isidakamizwa esihlobene nomphumela ovame ukungenakubekezelelwa) asidingeki.
Ngaphambi kokuqala ukwelashwa, ukuhlolwa kofuzo kungenziwa ukuze kunqume ukuthi unayo yini uhlobo lwegciwane elingavumelani ne-elbasvir ingxenye ye-Zepatier (eyaziwa ngokuthi i-polymorphism ehambisana ne-NS5a).
Ubude besikhathi semishanguzo yokwelashwa kusuka emavikini angu-12 kuya ku-16, kuye ngokuthi i-HCV genotype nesimo sokwelashwa.
| I-Genotype | Isimo sokwelashwa | Kuthathwa i-ribavirin? | Isikhathi |
| I-Genotype 1a | ukwelashwa-naïve ngaphandle kwe- elbasvir-resistant igciwane | cha | Amaviki angu-12 |
| ukwelashwa-naïve nge- elbasvir-ukumelana igciwane | Yebo | Amaviki angu-16 | |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon ngaphandle kwe -virus e-elbasvir-resistant | cha | Amaviki angu-12 | |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon ne- elbasvir-resistant virus | Yebo | Amaviki angu-16 | |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon + i-HCV protease inhibitor | Yebo | Amaviki angu-12 | |
| I-Genotype 1b | ukwelashwa-naïve | cha | Amaviki angu-12 |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon | cha | Amaviki angu-12 | |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon + i-HCV protease inhibitor * | Yebo | Amaviki angu-12 | |
| I-Genotype 4 | ukwelashwa-naïve | cha | Amaviki angu-12 |
| ngaphambili ephathwa nge-ribavirin + i-peginterferon | Yebo | Amaviki angu-16 |
* - I- Olysio (simeprevir), i-Victrelis (boceprevir), i-Incivek (i-telaprevir)
Imiphumela Ejwayelekile Ejwayelekile
Imiphumela emibi kakhulu ehlobene nokusetshenziswa kwe-Zepatier (eyenzeka ngeziguli ezingaphezu kuka-5%) yilezi:
- Ukukhathala
- Izinwele
- I-nausea
Uma isetshenziswe nge-ribavirin, imiphumela emibi yokwelashwa ebikwa kakhulu (eyenzeka ngeziguli ezingaphezu kuka-5%) ifaka:
- Izinwele
- Ukukhathala
- I-anemia
- I-nausea
- Ukuchithwa
- Ukuzithoba
- Ukuphelelwa umoya
- Ukungalali
- Ubuhlungu besisu
- Ukunciphisa ukudla
- Isikhukhula
- Ukuthukuthela
- Rash
Ukusebenzisana kwezidakamizwa
Imithi elandelayo akufanele isetshenziswe uma ithatha i-Zepatier ngoba ingabangela ukusebenzisana okukhulu kwezidakamizwa-izidakamizwa:
- Ama-antibiotics: i-nafcillin
- I-Anticonvulsives: i-Dilantin (phenytoin), i-Tegretol (i-carbamazepine)
- Ama-antifungals: Amaphilisi omlomo we-Nizoral (ketoconazole)
- Izidakamizwa ezivimbela kakhulu: Tracleer (bosentan)
- Imikhiqizo yemifino: Wort St. John's Wort
- Imithi elwa negciwane lesandulela ngculaza: i- Aptivus ( tipranavir ), i- Genvoya (i-elvitegravir, i-cobicistat, i-emtricitabine, i-tenofovir alafenamide), i- Intelence (etravirine), i- Invirase (i-saquinavir), i- Kaletra (i-lopinavir, i-ritonavir), i- Prezista (i-darunavir), i- Reyataz (atazanvir), i- Stribild ( i-elvitegravir, i-cobicistat, i-emtricitabine, i-tenofovir disproxil), i- Sustiva (efavirenz), i-
- Izidakamizwa ze-immunosuppressant ezisetshenziselwa ukuvimbela ukwenqatshwa kokufakelwa komzimba: i-cyclosporine
- Izidakamizwa ezisuka ku-Rifampin ezisetshenziselwa ukwelashwa kwesifo sofuba: i-Mycobutin, i-Priftin, i-Rifater, i- Rifamate, i- Rimactane, i- Rifadin
Ukucatshangelwa Ukwelashwa
Kuye kwabikwa ezifundweni zokwelashwa ukuthi i-1% yeziguli eziseZepatier zakhuphuka kakhulu ezinozini ze-enzyme zesibindi ezibonisa ubuthi obubangelwa isibindi, ngokuvamile noma emva kweviki lesishiyagalombili yokwelapha. Ngakho-ke, ukuhlolwa kwegazi okuhambisana nesibindi kuyadingeka ngaphambi kokuqala ukwelashwa njalo njalo phakathi ne-HCV yokwelashwa.
I-Zepatier akumele inqunywe iziguli ezinokukhubazeka okukhulu kwesibindi.
Ukusetshenziswa kwe-ribavirin kunqatshelwe ekukhulelweni futhi akufanele kunqunywe noma nge-Zepatier noma noma yikuphi omunye umuthi we-hepatitis C. Iziguli ezibhekene ne-ribavirin kufanele zelulelwe ukuba zigweme ukukhulelwa futhi zisebenzise okungenani izindlela ezimbili ezingekho ze-hormonal zokuvimbela ukukhulelwa ngesikhathi sokulashwa kanye nezinyanga eziyisithupha emva kokuqedwa kwelashwa.
Umthombo:
I-US Food and Drug Administration (FDA). "I-FDA ivumela i-Zepatier ukuthi ilashwe isifo esingenasifo sohlobo lwe-hepatitis C esingama-1 no-4." I-Silver Spring, e-Maryland; ukushicilelwa okukhishwe ngoJanuwari 28, 2016.
Merck. "I-Zepatier - Amaphuzu avelele ekuchazeni ulwazi." IKenilworth, eNew Jersey; kufinyelelwe ngoJanuwari 29, 2016.