Akuzona Zonke Izinto Eziphilayo Ezisebenza Ngendlela Efanayo Lapho Kuphathwa I-IBD
Iklasi elisha kunazo zonke izidakamizwa ezisetshenziselwa ukuphatha ukuvuvukala okubangelwa isifo sofuba esiswini (IBD) kuthiwa yi-biologics. Kodwa-ke, lolu luhlu olubanzi kakhulu lwemithi, futhi akusebenzi wonke umsebenzi ofanayo noma anikezwe ngendlela efanayo. Ezinye zivunyelwe ukwelapha uhlobo olulodwa lwe-IBD, kuyilapho ezinye zisetshenziselwa ukwelapha isifo soCrohn kanye nesifo sokulonda.
Ngenxa yokuthi izidakamizwa ze-biologic zishintsha amasosha omzimba ngezindlela ezihlukahlukene (okuyingxenye isizathu esenza basebenzele i-IBD), abantu abazithatha bangase bathambekele ekutholeni izinhlobo ezithile zokutheleleka. Kubalulekile, ngakho-ke ukuthatha izinyathelo zokuqinisekisa ukuthi ukuvikelwa kukhona endaweni yokuvimbela izifo. Abantu abane-IBD kufanele bathole imigomo , ngaphambi kokuba baqale i-biologic, kodwa ukugoma okuningi kungabuyekwa ngenkathi kuthatha i-biologic.
Odokotela bakhetha kanjani ukuthi iyiphi i-biologic agent ephakamise isiguli? Kunezimo ezihlukahlukene phakathi kwezidakamizwa, futhi eziningi zicatshangelwa. Lokhu kungabandakanya ukusebenza kahle (okuyinto kuhluke ngokusekelwe uhlobo lwesifo nesigaba), izindleko, kanye nokufaka umshwalense, phakathi kwezinye izici. Odokotela bazodinga ukuthatha zonke lezi zici ezicatshangelwayo, nokunye, lapho benza isincomo kumguli ngesilwane se-biologic.
Ngezansi kubheka ezinye ezimbalwa zezinto eziningana zezinhlobo eziningana zemithi ye-biologic.
Iziguli nodokotela bazofuna ukukala zonke lezi zici nabanye ngaphambi kokwenza isinqumo.
Cimzia
I-Cimzia (i-certolizumab pegol) i-blocker ye- necrosis factor (TNF) evunyiwe ngo-2008 ukuphatha isifo sika-Crohn. Ngo-2009 kwavunyelwa ukwelashwa isifo samathambo, kanye ne-psoriatic arthritis kanye ne-ankylosing spondylitis ngo-2013.
I-Cimzia ivame ukunikezwa umjovo nge-syringe ethandwayo ekhaya. I-Cimzia inikezwa ngemijovo emibili, eyokuqala elayishwa emthamo wokulayisha emasontweni 0, 2, no-4. Emva kwalokho, ukujozwa kokubili kunikezwa njalo emva kwamasonto amane. Olunye uhlobo lweCimzia lungumquba ohlanganiswe bese ujova ehhovisi likadokotela. Imiphumela emibi eyenzeka ngokuvame kakhulu nalesi sidakamizwa yizifo ezingaphezulu zokuphefumula (njengomkhuhlane), izifo ezibangelwa igciwane (njengokungukukhuhlane), ukuhlukumezeka, kanye nokutheleleka kwamagciwane.
Amaphuzu abalulekile mayelana neCimzia:
- I-Cimzia ivunyelwe ukuphatha isifo sikaCrohn
- I-Cimzia ivame ukunikezwa ekhaya ngomjovo
- I-Cimzia inikezwa ekuqaleni izikhathi ezingu-3 ochungechungeni lwemijovo emibili, amaviki amabili ngaphandle, okulandelwa ama-2 injections njalo emavikini amane
- Imiphumela emibi evamile ihlanganisa ukutheleleka kokuphefumula, izifo ezibangelwa amagciwane, ukuhlukumezeka, kanye nokutheleleka kwe-urinary tract
- I-Cimzia yisidakamizwa sesigaba B sokukhulelwa
- Isamba esincane seCimzia singadlulela esibelethweni
- I-Cimzia idinga ukuba ibe yisiqandisini
Entyvio
I-Entyvio (i-vedolizumab) , eyamukelwa ngoMeyi 2014, i-gut-homing α4β7 integrin ephikisanayo. Kucatshangwa ukuthi kusebenza ngokubophezela ku-α4β7 integrin, okuvimbela i-integrin ukuthi ingabangeli ukuvuvukala. I-Entyvio ivunyelwe ukusetshenziswa kubantu abadala abanesifo sikaCrohn noma i-ulcerative colitis.
I-Entyvio ihlale ihlinzekwa ukumnika, kungaba ehhovisi likadokotela, esibhedlela, noma esikhungweni sokungenisa ukumaketha. I-schedule yokulayisha ye-Entyvio yi-3 infusions eyenziwe ngamaviki amabili ngaphandle. Ngemuva kwaloko, ukugonywa kunikezwa cishe onke amasonto angu-8. Eminye yemiphumela emibi ingase ihlanganise ukutheleleka okubandayo, okuphezulu okuphefumula (umkhuhlane, ubuhlungu bomzimba), ubuhlungu bekhanda, izinhlungu ezihlangene, ukukhwehlela, umkhuhlane, ukukhathala, ukukhwehlela, ubuhlungu bokubuyela emuva, ukukhwabanisa, ukugwinya, ukutheleleka kwesono, ubuhlungu bomphimbo, nobuhlungu obukhulu .
Amaphuzu abalulekile mayelana ne-Entyvio:
- I-Entyvio ivunyelwe ukuba i-ulcerative colitis nesifo sikaCrohn
- I-Entyvio inikezwa ngokumnika ama-3 okuqala amanani, bese kuthi njalo emavikini angu-8
- Imiphumela emibi evamile ihlanganisa izifo (umkhuhlane, umkhuhlane, i-bronchitis, ukutheleleka kwesono); ubuhlungu emajoyini, emuva, emphinjeni noma emaphethelweni; izimpawu zesiphithiphithi, umkhuhlane, ukukhathala, ukukhwehlela, noma ukushaya; nokushona
- I-Entyvio yisidakamizwa se-B yokukhulelwa
- Okwamanje aziwa ukuthi i-Entyvio idlula ngesifuba
Humira
U-Humira (adalimumab) ungenye i-antibody monoclonal ne-TNF inhibitor esetshenziselwa ukuphatha abantu abane-IBD. Kuvunyelwe abantu abadala nabantwana abangaphezu kweminyaka engu-6 abanesifo sokulonda kwesifo sofuba noma isifo sikaCrohn. U-Humira ekuqaleni wavunyelwa ngo-2002, futhi wandisa ukuze asebenzise isifo sikaCrohn ngo-2007 kanye nesifo sokulonda kwesilonda ngo-2012. UHuma anganikezwa ekhaya ngokusebenzisa umjovo. Iziguli ziqeqeshwe ukuthi zinganikeza umjovo (noma zingenziwa ngosizo oluvela kulungu lomndeni noma umngane). Abanye abantu abane-Humira bangase babe nalokho okubizwa ngokuthi ukusabela kwesayithi yokujova , okuvuvukala, ubuhlungu, ukucheka noma ukubomvu endaweni lapho umuthi ujova khona. Lokhu kungasetshenziswa ukwelashwa ekhaya nge-ice noma imishanguzo ye-antihistamine (ukushintsha ama-injection sites njalo ngesonto nakho kuyasiza).
Amaphuzu abalulekile mayelana ne-Humira:
- I-Humira ivunyelwe kokubili isifo sikaCrohn nesifo sofuba esiswini
- U-Humira unikezwa ekhaya nge-self-injection
- I-Humira iqalwa ngamagciwane angu-4, ilandelwa ama-2 injection 2 amasonto kamuva, bese-ke injection eyodwa njalo ngesonto
- Imiphumela emibi ejwayelekile ifaka ubuhlungu noma ukucasuka endaweni yokujova kanye nokukhanda ikhanda, ukuqhuma kanye nesicashu
- U-Huma yisidakamizwa se-B yokukhulelwa
- Izinsana ezalwa ngamama ezithola uHumira kumele zingatholi imithi ephilayo ezinyangeni ezingu-6
- UHumira udinga ukushisa
Khipha kabusha
I-therapy yokuqala ye-biologic evunyelwe ukusetshenziswa kubantu abane-IBD yi- Remicade (i-infliximab) , eyamukelwa ngo-1998. I-Remicade i-anti-monoglonal antibody ebizwa ngokuthi i-TNF inhibitor futhi inikezwa iziguli nge-IV. Lokhu kungenziwa ehhovisi likadokotela, kodwa kaningi kutholakala esikhungweni sokungeniswa, okuyisakhiwo esikhethekile esenzelwe ukuphatha imithi ye-IV. I-Remicade ingasetshenziselwa ukwelapha isifo sikaCrohn noma i-ulcerative colitis, futhi ibuye ivumele izingane ukuba zincane njengo-6, ezimweni ezithile. I-Remicade kucatshangwa ukuthi isebenza kubantu abane-IBD ngoba inqanda i-TNF, okuyinto into eyenza ukuvuvukala emzimbeni.
Amaphuzu abalulekile mayelana ne-Remicade:
- I-Remicade inikezwa ngu-IV
- I-Remicade ivunyiwe isifo se-Crohn nesifo sofuba esiswini
- Izinyathelo zokuqala ezintathu zinikezwa (ngemuva kwesilinganiso sokuqala, okwesibili kungamaviki amabili kamuva, okwesithathu kungamaviki amane emva kwalokho)
- Emva kwamanani okuqala, unikezwa cishe onke amasonto angu-8 (ngezinye izikhathi ngokushesha uma kudingeka)
- Imiphumela emibi yilezi zifo zesisu, isicashu, ukukhathala nokuhlanza
- I-Remicade yisidakamizwa sesigaba B sokukhulelwa
- I-Remicade ayibonakali idlule ubisi lwebele
Simponi
I-Simponi (i-golimumab) i-TNF inhibitor evunyelwe ukwelapha i-ulcerative colitis. I-Simponi yavunyelwa kuqala ngo-2009 ukuphatha i-arthritis ye-rhumum, i-psoriatic arthritis, ne- ankylosing spondylitis . Ngonyaka ka-2013 kwamukelwa ukuphatha ukwelashwa kwesifo sofuba. I-ankylosing spondylitis yisimo esingahlotshaniswa ne-ulcerative colitis, okusho ukuthi le mithi ingasetshenziselwa ukuphatha kokubili (noma) ukuphazamiseka. U-Simponi unikezwa ekhaya, ngakho iziguli ziqeqeshwa umhlinzeki wezempilo ukuthi angazifaka kanjani (mhlawumbe ngokwazo noma ngosizo). Ezinye izimpendulo ezimbi ku-Simponi zithola ukutheleleka okubangela izifo ezinjengomkhuhlane, izimpawu ezifana nomkhuhlane noma i-laryngitis, kanye nokutheleleka ngegciwane njengohlobo lomkhuhlane. Ukuba nokubomvu, ubuhlungu nokuhlushwa endaweni yokujova, ngokuvamile ephathwa ngeqhwa nama-antihistamine, kungenye impendulo engalungile.
Amaphuzu abalulekile mayelana ne-Simponi:
- I-Simponi ivunyelwe ukwelapha i-ulcerative colitis
- I-Simponi inikezwa umjovo ekhaya
- I-Simponi iqalwe ngamagciwane amabili, ilandelwa umjovo ongu-1 ngemva kwamasonto amabili, nomjovo ongu-1 njalo ngemva kwamasonto amane ngemuva kwalokho
- Imiphumela emibi evamile ifaka ubuhlungu noma ukucasuka endaweni yokujola kanye nokuphefumula okuphezulu noma ukutheleleka ngegciwane
- I-Simponi yi-Type B yokukhulelwa kwezidakamizwa
- Okwamanje aziwa ukuthi i-Simponi izoyithinta kanjani ingane engumntwana
- I-Simponi kumele ibe seqandisini
Stelara
I-Stelara (i-ustekinumab) isilwane esiphelele se-human monoclonal immunoglobulin. Kwaqala kuqala ngo-2008 njengokwelashwa kwe-plaque psoriasis futhi ngo-2016 ukuphatha isifo sikaCrohn. I-Stelara isebenza ukunciphisa ukuvuvukala kwesifo sikaCrohn esibangelwa ukukhomba i-interleukin (i-IL) -12 ne-IL-23, okucatshangwa ukuthi idlala indima ekuthuthukiseni ukuvuvukala emathunjini. Umthamo wokuqala we-Stelara unikezwa ngokumnika, esikhungweni sokungeniswa noma ehhovisi likadokotela. Emva kwalokho ukumnika kokuqala, uSlara angathathwa ekhaya ngomjovo onikezwa njalo emavikini angu-8. Iziguli zingazinikela umjovo ngemuva kokuqeqeshwa ngumhlinzeki wezempilo. Eminye yemiphumela emibi ejwayelekile ebonakala kubantu abanesifo sikaCrohn esithatha u-Stelara kufaka phakathi ukuhlanza (ngesikhathi sokungcoliswa kokuqala), ubuhlungu noma ukubomvu endaweni yokujova, ukuhlakulela, nokutheleleka okunjengomkhuhlane, isifo sovubelo, i-bronchitis, i-urinary tract ukutheleleka, noma isifo se-sinus.
Amaphuzu abalulekile mayelana noStera:
- I-Stelara ivunyelwe ukuphatha isifo sikaCrohn
- Umthamo wokulayisha we-Stelara unikezwa ukumnika futhi emva kwalokho unikezwa ngamagciwane ekhaya
- Abantu abathatha izibhamu ze-allergies kufanele bakhulume nodokotela wabo mayelana nokuthi kungenzeka yini ukuphendula okweqile kanye ne-Stelara
- Imiphumela emibi evamile ihlanganisa ukutheleleka, ukusabela kwesayithi, ukuhlanza
- I-Stelara yisidakamizwa se-B yokukhulelwa
- Kucatshangwa ukuthi uStelara udlulela esibhedlela
- I-Stelara kumele ibe seqandisini
> Imithombo:
> Janssen Biotech, Inc. "Umhlahlandlela Wemithi Elula." May 2013.
> Janssen, Inc. "I- Stelara (ustekinumab) Ukuchaza Ulwazi ." Stelarainfo.com. Aug 2016.
> Umama Oyingane. "I-Certolizumab Pegol (Cimzia) nokukhulelwa." MotherToBaby.org. Aug 2015.
> Takeda Pharmaceuticals, Inc. "Mayelana ne-Entyvio." Entyvio.com. 2015.
> UCB, Inc. "I- Cimzia (Certolizumab Pegol) Umhlahlandlela Wezokwelapha ." Cimzia.com. Ngo-Apr 2016.