Izidakamizwa ze-biologic , eziye zathengiswa ngezinhlobo ezithile ze- arthritis evuvukala kusukela ngo-1998, zilawulwa yi-infusion noma self-injection . Imiphumela emibi, engenzeka ngalezi zidakamizwa, ibizwa ngokuthi ukusabela kwe-infusion noma ukusabela kwendawo yomjovo. Imisindo iyayethusa, akunjalo? Kodwa, kufanele wazi ukuthi ukusabela akuvamile ukuthi kunzima futhi kuvame ukudlula ngaphandle kokungenelela.
Amathonya Okuvamile Okumnika Amaphutha
Izinkinga ezivamile ezihlobene nokuthathwa kwamakhanda zingabandakanya ukukhanda ikhanda, isisulu sezinyosi, i-urticaria (ama-hives), i-pruritus (itching), i-rash, i-flush, i-fever, i-chills, i-tachycardia (ukushaya kwenhliziyo okusheshayo), ne-dyspnea (ukuphefumula okunzima).
Nakuba kungavamile, ukusabela okunzima noma ukusabela kwe-anaphylactic kungenzeka. Ezimweni ezinjalo, ukuqina kwesifuba, i-bronchospasm, i-hypotension (umfutho wegazi ophansi), i-diaphoresis (i-sweating), noma i-anaphylaxis (isifo esibi kakhulu esingaphansi kwamaprotheni angaphandle okubangelwa ukuchayeka kwangaphambilini) kungenzeka. Uma ukusabela okunzima kuqhubeka, ukwelashwa kwe-biologic kufanele kumiswe ngokushesha kanye nokunakekelwa okuphuthumayo okunikeziwe. Kwezinye izimo, imishanguzo yangaphambi kwe-acetaminophen, i-antihistamine, kanye ne-corticosteroid encane eyenza isikhathi eside ingasiza ekuvimbeleni ukusabela kwe-infusion.
Ngokusho kwabalobi be- Rheumatoid Arthritis: Ukutholakala Kokuqala Nokunakekelwa Kwamanje , idatha yokwaziswa kwezomtholampilo yembule ukuthi nakuba iziguli ezingaba ngu-20% eziphathwa nge- Remicade (i-infliximab) zine-reaction infusion, ngaphansi kwe-1% yeziguli eziphathekayo eziphethwe yi-Remicad kuphela ama-2.5% wokumpompela kweziguli phakathi kweziguli ezithintekayo ezibangelwa ukuguqulwa kwezidakamizwa kwaholela ekwenzeni ukuphuma kwesidakamizwa.
Ngokujwayelekile, ukusabela kwamapusion okuhambisana nokukhipha i-Remicade kwenzeka ngesikhathi sokumnika noma ngaphakathi kwamahora amabili ngemva kokukhipha ukumiswa.
Ake sicabangele ukuthi ukuchazwa kolwazi kwezinye izidakamizwa ze-biologic kwembula, ukukhumbula ukuthi izilingo ezahlukene zokwelashwa azikwazi ukuqhathaniswa (isib. Ukukhipha imiphumela yesilingo akunakuqhathaniswa nemiphumela ye-Simponi yecala) kanye nedatha yesilingo somtholampilo angeke ihambisane nemvamisa yangempela yangempela sebenzisa.
- I-Simponi Aria: Esigabeni esilawulwayo soHlingo 1 (ngesonto 24), 1.1% ye-Simponi Aria infusions yayihlotshaniswa nesenzo sokungcoliswa uma kuqhathaniswa no-0.2% we-infusions eqenjini lokulawula. I-Rash yi-reaction evamile kakhulu yokumnika amandla. Azikho ukusabela okungathí sina kwe-infusion okubikiwe.
- Orencia (abatacept): Ucwaningo lwe-Orencia III, IV, noV lwembula ukuthi ukusabela okunamandla kwamagciwane kwakuvame kakhulu phakathi kweziguli ezithathwe i-Orencia uma kuqhathaniswa ne-placebo (9% vs. 6% ngokulandelana). Izenzakalo ezibikwa kakhulu kunesizungu, ukukhanda ikhanda, kanye ne-hypotension (1-2%). Kubalwa kunamaphesenti angu-1 wezilwane eziphethwe i-Orencia eziye zaphela ukusetshenziswa kwezidakamizwa ngenxa yokusabela okunamandla kokumnika amandla. I-Anaphylaxis yenzeke ngaphansi kwezingu-0.1% zeziguli eziphathwe u-Orencia.
- I-Actemra (tocilizumb): Esifundweni esilawulwa ngamasonto angu-24 esilawulwayo, ukuphendula okunamandla kwamagciwane kwenzeka ngo-7-8% weziguli, kuye ngokuthi yiziphi izilinganiso ezimbili zika-Actemra ezisetshenzisiwe, uma kuqhathaniswa no-5% eqenjini le-placebo. Isenzakalo esivame kakhulu ngesikhathi sokumnika kwakungu-hypertension (1%). Izenzakalo ezivame kakhulu ngaphakathi kwamahora angu-24 wokumnika ukukhishwa kwamakhanda (1%) nokuthinta isikhumba (1%). Izenzakalo azange zenze ukuyeka noma ukunciphisa ukwelashwa.
- I-Rituxan (rituximab): Ulawulo lwe-Rituxan lungabangela ukungathí sina, kufaka phakathi ukuphazamiseka kwamandla okufiphaza. Ukushona okungakapheli amahora angu-24 e-Rituxan ukumnika kwenzeka. Amaphesenti angaba ngu-80 wezinguquko ezibulalayo ezifayo zenzeke ngokuhambisana nokumnika kokuqala.
Ku-Rituxan RA uhlanganisa izifundo zokulawulwa kwe-placebo, ukusabela okunamandla kwamaphutha (imfiva, ukubola, ama-rigor, ama-pruritus, i-urticaria noma i-rash, i-angioedema, i-sneezing, i-throat irritation, ukukhwehlela, noma i-bronchospasm, ene-hypotension noma i-hypertension ehlanganisiwe) % iziguli eziphathwe yi-Rituxan zilandela ukumnika kwawo kokuqala, uma kuqhathaniswa ne-19% yeqembu le-placebo. Isimo sokuphendula okunamandla kwamandla okulandela ukulandela ukukhishwa kwesibili kwe-Rituxan noma indawo ye-placebo yehlile ku-9% no-11%, ngokulandelana. Ukusabela okunamandla okukhulu kwe-infusion kwabhekwe <1% weziguli kunoma yiliphi iqembu lezokwelapha.
Ukuguqulwa kwesidakamizwa kwakudingeka ku-10% weziguli eziphathwe yi-Rituxan ngokumelene no-2% weqembu le-placebo.
Izimpembelelo Zemizwa Ejwayelekile Ejwayelekile
Ngezidakamizwa ze-biologic ezenziwa ngaphansi kwesigcawu, ukuphendula kwe-injection site kungenziwa kepha ngokuvamile akukho ukwelashwa okudingekayo futhi ukuyeka isidakamizwa akudingekile.
Abacwaningi babuye babheka idatha yokuhlolwa komtholampilo ukuze bahlole imvamisa ye-injection site reaction. Ngenkathi inikeza umqondo othile, khumbula, ukuhlolwa okuhlukile kwemitholampilo akunakuqhathaniswa futhi idatha yesilingo emtholampilo ayikhombisi ukuthi kwenzekani ngomkhuba wangempela.
- Enbrel (etanercept): Ezilingo ezilawulwa yi-placebo ngezimo ze-rheumatologic, cishe ama-37% weziguli eziphathwe nge-Enbrel ezakhiwe ngendlela yokusabela kwesayithi. Zonke izimpendulo zendawo yomjovo zachazwa njengezincani ezilinganiselwe (i-erythema, i-itching, ubuhlungu, ukuvuvukala, ukuphuma kwegazi, ukulimaza) futhi ngokuvamile ayiholele ekunqandeni izidakamizwa. Ukusabela kwesayithi lokungenwa, ikakhulukazi izinsuku ezihlala ezinsukwini ezintathu kuya kwezingu-5, ngokuvamile kwenzeka ngenyanga yokuqala futhi kamuva wehla emvamisa.
- Humira (adalimumab): Ezilingo ezilawulwa yi-placebo, iziguli ezingu-20% eziphathwa nge-Humira zenzelwe ukusabela kwendawo yomjovo (i-erythema, itching, i-hemorrhage, ubuhlungu noma ukuvuvukala), uma kuqhathaniswa nama-14% weziguli ezithola indawo ye-placebo. Iningi lamanzi ekuphenduleni isayithi lachazwa njengobumnene futhi ngokuvamile akudingi ukuyeka ukukhishwa kwezidakamizwa.
- I-Simponi (golimumab): Ezilingo ezilawulwa yiSigaba II / III, ama-3.4% wezigulane eziphathekayo zinezimpendulo zendawo yomjovo uma kuqhathaniswa ne-1.5% eqenjini lokulawula. Iningi le-injection site ukusabela kwaba mnene futhi elinganiselwe, kanye ukubonakaliswa okuvame kakhulu ukuba i-erythema.
- I-Cimzia (certolizumab pegol): Kwakukhulunywe ukuthi kungenzeka ukuthi injini ye-injection site reaction neCimzia emininingwaneni yokwahlulela, echazwe njengengavamile, kodwa akukho imininingwane eningi eyanikezwa.
Imithombo:
I-Arthritis Ye-Rheumatoid: Ukwelashwa Kwangaphambili Nokuxilongwa. Cush, Weinblatt, iKavanaugh. 2010. Uhlobo lwesithathu. I-Professional Communications, Inc.