Indlela Ephumelela Ngayo I-Zinbryta Futhi Yimiphi Imiphumela Yayo Yomphumela?
Ngo-May 2016, i-United States Yokudla Nezidakamizwa Zokuphathwa Kwezidakamizwa yavuma ukwelashwa kwesifo sokuguqula isifo se-Zinbryta (daclizumab) sokwelapha i -MS yokubuyisela emuva .
I-Zinbryta imithi enikezwe ngaphansi kwesikhumba njalo ngemva kwamasonto amane. Kukholakala ukuthi kusebenza ngokuvimbela isayithi elibophayo kwi-interleukin-2 (i-IL-2) -i-molecule esimisweni somzimba sokuvikela omzimba esenza ama-T akho amaseli asebenze.
Ngokuvimbela i-receptor kuma-interleukin-2, amangqamuzana e-T awasebenziswanga ukuhlasela umgogodla we-myelin ebuchosheni bakho nasendlini yomgogodla.
I-Zinbyta ingase isebenze ngokwandisa amangqamuzana omzimba omzimba obizwa ngokuthi amangqamuzana ebulalayo, abulale amaseli aseT activated ahlelwe ukuhlaselwa emgodini we-myelin.
I-Science Behind Zinbryta
Esifundweni esikhulu eNew England Journal of Medicine, abathintekayo abangu-1841 abane-MS ekubuyiseleni kabusha babekwa ngezikhathi ezithile ukuthola i-dobryta (daclizumab) njalo ngemva kwamasonto amane noma i- Avonex (interferon β-1a) masonto onke cishe iminyaka emithathu.
Imiphumela yabonisa ukuthi abahlanganyeli abathola i-Zinbryta banamaphesenti angu-45 abambalwa ama-MS aphinde abuyele ngonyaka kunabo abathola i-Avonex.
Ngaphezu kwalokho, inani lemishaya ye-MS entsha noma ekhulisa nge-MRI yayingaphansi kwamaphesenti angu-54 kulabo abathola i-daclizumab, uma kuqhathaniswa nalabo abaphathwa nge-Avonex.
Kwesinye isifundo e- Lancet , cishe abahlanganyeli abangu-600 abane-MS ekubuyiseleni kabusha babenomsebenzi wokuthola isilinganiso esincane seZinbryta (150mg), isilinganiso esiphezulu seZinbryta (300mg), noma injection ye-placebo.
Abahlanganyeli noma abacwaningi babengazi ukuthi yimuphi umjovo owanikezwa-lokhu kubizwa ngokuthi ucwaningo oluphindwe kabili futhi luvikela imiphumela ngenxa yokungabi nandaba. Abahlanganyeli bathola izijovo masonto onke cishe ngonyaka.
Imiphumela iphakamisa ukuthi uma kuqhathaniswa ne-placebo, umthamo ophansi weZinbryta (150mg) unciphisa izinga lokuphindaphinda kwe-MS ngamaphesenti angu-54, kanti isilinganiso esiphezulu (300mg) sinciphise izinga lokuphindaphinda kwe-MS ngamaphesenti angu-50.
Ngakho-ke, umthamo ophansi noma ophakeme wanikeza imiphumela emihle kakhulu, yingakho umthamo ophansi usetshenziselwa ukunciphisa imiphumela emibi.
Imiphumela Engahle Yenzeke YaseZinbryta
Njengazo zonke izidakamizwa, iZinbryta ithatha amathuba okuba nemiphumela emibi, ezinye mhlawumbe ngisho nokusongela ukuphila. Lezi zibalwa njengesixwayiso sebhokisi bese zifaka:
- ukulimala okukhulu kwesibindi okungase kubulale
- ukuvuvukala kwamakholoni
- ukusabela kwesikhumba
- Ama-lymph nodes akhuliswa
Ezinye izixwayiso zezidakamizwa zifaka phakathi ukuthi kungenzeka yini ukubhekana nesifo esibi kakhulu, futhi ingozi eyengeziwe yokwanda kwezifo nokucindezeleka, okufaka ukucabanga kokuzibulala.
Ngokomphumela omubi ovamile, labo ababikiwe ocwaningweni ngokuqhathanisa neZinbryta ku-Avonex bahlanganisa:
- izimpawu ezibandayo
- ukutheleleka okuphezulu kokuphefumulela noma ukushiswa kwe-bronchitis
- i-eczema, ukuqhuma, noma esinye isenzo senhliziyo
- umkhuhlane
- ubuhlungu bomphimbo
- i-lymph nodes ekhulisiwe
Ezinye imiphumela ezibikwa ngokuvamile ezibikiwe zihlanganisa ukunyuka kwe-enzyme yesibindi nokucindezeleka.
Ngenxa yokuthi kungenzeka lezi zingozi ezimbi, i-Zinbryta inconywa kuphela kubantu abane-MS abangazange baphendule eminye imithi emibili noma ngaphezulu.
Ngaphezu kwalokho, ingabekwa kuphela ngaphansi kohlelo olubizwa ngokuthi i-Risk Assessment and Mitigation Strategy (REMS). Lokhu kusho ukuthi i-neurologist yakho kufanele iqinisekiswe ukuthi ikuphatha nge-Zinbryta.
Inhloso yalolu hlelo ukuqinisekisa ukuthi i-neurologist yakho ikuqaphele imiphumela engalungile, njengokuhlola ukuhlolwa kwesibindi segazi kwesibindi.
Izwi elivela
Kuyakha amandla uma ukwelashwa okusha okusha kwesifo se-MS kuvunywa yi-FDA, futhi izindaba ezinhle ukuthi kukhona okuningi emgqeni. Uma kuthiwa, le mithi ingase ibe yinto efanele noma ingabe ingakulungile.
Kuningi okufanele ucabangele lapho ukhetha ukuphathwa kwe-MS njengeminye yemibandela yezokwelapha, kungakhathaliseki ukuthi ungakhulelwa esikhathini esizayo esiseduze, futhi kungenzeka ukuthi ungakhukhumeleki nemiphumela emibi ehambisana nayo.
Futhi, iZinbryta kungenzeka ukuthi ingabi "ngcono" kunokwelashwa kwakho okwamanje okwenziwa yi-MS. Kube nesifundo esisodwa kuphela esilinganisa ne-Avonex. Ngakho ngenkathi iZinbryta inciphisa inani lokubuyiselwa kabusha eliqhathaniswa ne-Avonex, asikwazi ukwenza lokhu kwezinye izindlela zokwelapha ze-MS.
Imithombo:
Igolide ne-al. Inqubo ye-Daclizumab ephezulu yokuvunwa ekubuyiseleni kabusha-ukukhipha izifo eziningi (UKUKHETHA): isilingo esilawulwa ngokungahleliwe, esiphindwe kabili, esibucayi. I-Lancet. 2013; 381) 9884): 2167-75.
Kapos L et al. I-Daclizumab HYP ngokumelene ne-Interferon Beta-1a Ukubuyiselwa Kwama-Multiple Sclerosis. N Engl J Med . 2015; 373 (15): 1418-28.
UMilo R. Ukusebenza nokuphepha kwe-daclizumab kanye nendima yayo engaba khona ekwelapheni i-multiple sclerosis. I-Ther Adv Neurol Disord. 2014; 7 (1): 7-21.
Ukuphathwa Kwezokudla Nezidakamizwa zase-US Ukuchaza Ulwazi. (2016). I-Zinbryta.