U-Orencia (abatacept) wamukelwa yi-US Food and Drug Administration (FDA) ngo-Dec 23, 2005 njengomuthi wakamuva wokuphatha izibonakaliso nezimpawu zesifo samathambo . U-Orencia wajoyina ezinye ezintathu ze-DMARD eziphilayo ngesikhathi sokunciphisa ukuqhuma kokulimala kwesakhiwo, kuhlanganise nesifo se-necrosis se-tumor (izidakamizwa ezilwa no-TNF):
I-Simponi (golimumab) ne-Cimzia (certolizumab pegol), ama-blocker amabili e-TNF, avunyelwe kamuva.
I-Orencia ivunyelwe ngokulinganisela ezigulini ze-arthritis ezikhuthele kakhulu eziphethwe yisifo sofuba eziye zathola impendulo engenele kwesinye sezidakamizwa eziguqula isifo (i-DMARD) okungezelelwe ku-antagonists we-TNF kufaka:
- I-rheumatrex (methotrexate)
- I-Arava (i-leflunomide)
- I-Plaquenil (i-hydroxychloroquine)
- I-Azulfidine (i-sulfasalazine)
Indlela Orencia Ephathwa Ngayo
Njengoba kufana ne-Remicade (infliximab), i-Orencia inikezwa njenge-infusion emangcwabeni (IV). I-Orencia nakuba iphathwa ngaphezu kwemizuzu engu-30, ngokungafani ne-infliximab ephathwa ngaphezu kwamahora amabili.
Ukulandela ukuphathwa kokuqala, u-Orencia unikezwa emavikini amabili no-4, bese kuthi njalo emva kwamasonto amane emva kwalokho. I-Orencia ingase isetshenziswe njenge-monotherapy (yedwa) noma ihambisane ngokunye namanye ama-DMARD angewona abaphikisi be-TNF ngenxa yengozi eyengeziwe yokwehliswa inhlanganisela.
Kusukela ngoJulayi 2011, ukubunjwa okuzimele okungenakwenjelwa kwe-Orencia kwamukelwa yi-FDA.
Imiphumela Ehlangene Ehlanganiswe no-Orencia
Imiphumela emibi ifaka kodwa ayikhawulelwe ku:
- ukusabela okuqhamukayo okungajwayelekile ukuthi kungasongela ukuphila
- ukutheleleka
- Izinkinga zokuphefumula (ikakhulukazi ezigulini ezinezifo ezingaphansi kwe-chronic obstructive pulmonary and malignancies)
Amaqiniso Okucatshangelwa Ngaphambi Kokuzama U-Orencia
Izindleko zika-Orencia kufaka phakathi ukuqapha kwayo cishe kakhulu kunezingqinamba ze-TNF eziphikisayo i-adalimumab ne-etanercept kodwa ngaphansi kwe-infliximab. U-Orencia uye wabonisa inzuzo emnene kuphela uma isetshenziswe yedwa ngakho kungcono kunqunywe omunye i-DMARD njengemettretrexate noma abanye ukufeza imiphumela emihle.
Kuze kube khona okunye okuhlangenwe nakho komtholampilo no-Orencia, odokotela abathile bayayigcina iziguli eziye zahluleka okungenani ezimbili kulabo abathathu abathintekayo be-TNF (kulinganiswa nemiphumela emibi noma ukungabi nzuzo). Lezi zidakamizwa ze-arthritis ziye zasemakethe kusukela i-etanercept yasungulwa ngo-1999 futhi ikhombisa isilinganiso esihle senzuzo.
Orencia vs. Anakinra
I-Anakinra ayisoloko isetshenziselwa ukwelapha isifo samathambo ngenxa yesidingo sayo somjovo wansuku zonke kanye nenzuzo elinganiselwe uma kuqhathaniswa nabamelene ne-TNF abavimbela umsebenzi we-TNF (i-cytokine noma isithunywa phakathi kwamaseli). I-TNF iyinhlanganisela enendima ebalulekile ekwenzeni ukuvuvukala nokulimala ku-arthritis ye-rheumatoid.
Amangqamuzana e-T nawo adlala indima ekwenzeni izibonakaliso zemitholampilo kanye nezimpawu zesifo samathambo esifubeni. U-Orencia uvimbela isignali egazini okudingekile ukuba amaseli e-T enze umonakalo.
I-Kineret (anakinra) ivimbela i-cytokine IL-1 edlala indima emonakalweni wethambo eliyingxenye ye-arthritis ye-rheumatoid.
Impendulo eyanikezwa nguScott J. Zashin, MD, uprofesa wothisha wezempilo e-University of Texas Southwestern Medical School, Division of Rheumatology, eDallas, eTexas. UDkt. Zashin ungudokotela ozofika esibhedlela sasePresbyterian yaseDallas nasePlano. Ungumunye we-American College of Physicians kanye ne-American College of Rheumatology kanye nelungu le-American Medical Association.