Izidakamizwa ze-Biologic Zingafani Ngokuphumelelayo Ngomuntu Obekezelayo
I-TNF (i-tumor necrosis factor) i-blockers yaba yindlela yokwelashwa yeziguli ezine- arthritis ye-rheumatoid noma uhlobo oluthile lokuvuvukala kwe-arthritis kusukela ngo-1998 ngenkathi i- Enbrel (etanercept) ivunyelwe i-FDA. Ezinye izidakamizwa ze-biologic eziningi ziye zavunywa futhi zithengiswa kusukela ngaleso sikhathi.
I-TNF blockers ihlanganisa, i-Enbrel (etanercept), i- Remicade (i-infliximab), i- Humira (i-adalimumab), i- Simponi (i-golimumab) ne- Cimzia (i-certolizumab pegol).
Kukhona nezinye izidakamizwa ze-biologic, njenge- Orencia (abatacept), i- Rituxan (rituximab), i- Actemra (tocilizumab), ne- Kineret (anakinra) engahlose i- TNF.
Uma uphathwa nge-blocker ye-TNF, kungase kudingeke ukuthi ushintshe ku-blocker ehlukile ye-TNF noma esinye isidakamizwa se-biologic ngesikhathi esithile. Izizathu ezifanele zokushintsha zingafaka:
- Impendulo engathandeki ekwelapheni
- Imiphumela emibi engathandeki yokwelapha
- Ukuphumelela kunciphise ngokuhamba kwesikhathi
Sabuza isazi sezinhlanzi uScott J. Zashin, MD imibuzo embalwa mayelana nokushintsha ukuvimba kwakho kwe-TNF.
- Kungenzeka yini ukuthi isiguli sibe nempendulo engcono kwi-blocker ehlukile ye-TNF noma ingabe injalo?
- Ingabe isiguli singabuyela emuva kwi-blocker ye-TNF ngemva kokuyiyeka?
UDkt. Zashin waphendula wathi, "Iziguli ezingamaphesenti angama-70 ezine-arthritis ye-rheumatoid eziqala ukuvimbela izifo ze-TNF zizokwenza ngcono kakhulu esimweni sabo. Iziguli eziningi zizozuza uma methotrexate (i-Rheumatrex, i-Trexall) noma enye i- DMARD (ukuguqulwa kwezifo anti-rheumatic drug) ihlanganiswe ne-blocker ye-TNF.
Uma isiguli singaphenduli nge-block ye-TNF emva kokuqala kwezinyanga ezintathu, ukushintshela komunye kuzothuthukisa amathuba okuzuza. Eqinisweni, noma ngabe isiguli asizange siphendule izidakamizwa ezimbili ze-TNF, kungase kube usizo ukuzama okwesithathu. "
Empeleni, imiphumela yocwaningo (eyanyatheliswa ngoJuni 2010 ngo-Rheumatology) yaphetha ngokuthi iziguli ezine- spondyloarthritis ezahluleka ukuphendula ku-Enbrel of Remicade njenge-agent yokuqala, zaphendula uHuma ngemuva kokushintsha, kungakhathaliseki ukuthi zishintshe yini.
Okunye ukutadisha okuthakazelisayo, okushicilelwe kuRheumatology Clinic and Experimental ngo-2013, kwembulwe ukuthi iziguli ezine-spondyloarthritis zakwazi ukuhlala isikhathi eside ngezinhlamvu ze-TNF kuneziguli zesifo se-rheumatoid arthritis, ngokuyinhloko ngenxa yesigcawu se- ankylosing spondylitis seziguli. Ngomabili i-rheumatoid arthritis kanye ne-spondyloarthritis, iziguli zakwazi ukunamathela nge-Enbrel no-Humira isikhathi eside uma kuqhathaniswa ne-Remicade.
UDkt. Zashin wanezela ukuthi, "Iningi lama-rheumatologists alisebenzisanga i-Kineret ngokujwayelekile ukuphatha i-arthritis ye-rheumatoid ngenxa yokunciphisa ukusebenza kwayo futhi idinga ukujova nsuku zonke. Noma kunjalo, i-Kineret iye yaba usizo kakhulu kulabo abaye bathola ukuthi bane-arthritis yezingane, okuthiwa isifo sika-Still . "
Futhi, ngokusho kukaDkt. Zashin, kuyilapho iziguli eziye zayeka ukwelashwa nge-Enbrel noHuma zingabuyela emuva kulesi sidakamizwa ngaphandle kokukhathazeka, labo abaye baqeda Ukubuyisela isikhathi eside isikhathi eside babhekana nengozi yokuphendula ukukhipha okungaba yingozi.
Imithombo:
Ukuguquka kusuka ku-infliximab noma i-etanercept kuya ku-adalimumab kumagciwane angaxhasi noma angaxolisi nge-spondyloarthritis: isifundo seminyaka engu-4. Spadaro. A. et al. I-Rheumatology (i-Oxford). Juni 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20223813
Ukusinda kwezidakamizwa kwenkambo yokuqala yama-anti-TNF amanxusa eziguli ezine-arthritis ye-rheumatoid ne-sponeythriloarthritis ye-seronegative: ukuhlaziywa kusuka ku-database ye-MonitorNet. Scire CA et al. I-Rheumatology yezokwelapha kanye nokuhlola. Novemba-Disemba 2013.
http://www.ncbi.nlm.nih.gov/pubmed/23981363
Impendulo, ngokwengxenye, inikezwe nguScott J. Zashin, MD, uprofesa wothisha otholwe esibhedlela 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. UDkt. Zashin ungumbhali we-arthritis ngaphandle kwemizwa - Isimangaliso se-anti-TNF Blockers kanye nombhali-mbhali we-Natural Arthritis Treatment.