I-FDA Ebonisa Ukudakwa Kwezidakamizwa Ukunciphisa I-Gut Fat Ehlanganisiwe ngo-15-18%
Ukuhlukaniswa
I-Egrifta (tesamorelin) iyindlela yokujova, yokwenziwa kwe-hormone-release hormone (GHRH) evunyiwe yi-US Food and Drug Administration (FDA) ngoNovemba 2010 ekwelapheni i -lipodystrophy ehambisana ne-HIV .
Mayelana ne-Lipodystrophy ehlanganisiwe ne-HIV
I-lipodystrophy ehambisana ne-HIV yisimo esibonakala ngokuphindaphindiwe ngokuphindaphindiwe kwamafutha omzimba.
Isimo sivame ukuveza ngokucwiliswa okucacile kobuso, izintambo, noma iziphetho, kuyilapho ngokuvamile kubangela ukuba amafutha aqoqe eduze kwesisu, isifuba, noma emuva entanyeni (ekugcineni okubizwa ngokuthi "i-buffalo hump" -ngathi ngokubukeka).
I-lipodystrophy ehlobene ne-HIV ivame ukuxhunyaniswa ngezinhlobo ezithile zemithi yokulwa negciwane lesandulela ngculaza , kuhlanganise ne- protease inhibitors (i-PIs) kanye ne- nucleoside reverse transcriptors (NRTIs) njenge-Zerit (stavudine) ne-Videx (didanosine). Isimo singase sibe nomphumela wokutheleleka nge-HIV ngokwawo, ikakhulukazi ezithinta iziguli ezingakaqali ukwelashwa kwama-antiretroviral.
Nakuba i-lipodystrophy ibonakala ingaphansi kakhulu kubantu abanesandulela ngculazi kusukela lapho kuqaliswa izidambisigciwane ezintsha, kuqhubeka kuyinkinga ngoba lesi simo asivamile ukuguqulwa uma kwenzeka futhi ngisho noma imishanguzo yesimangalo imisiwe.
Ukubonisa Ukwelashwa Nemiphumela
I-egrifta iboniswa ngeziguli ezinegciwane lesandulela ngculaza ikakhulukazi ukunciphisa amafutha angaphezu kwama-visceral (okungukuthi, amafutha athola emgodini wesisu nangasemzimbeni wangaphakathi).
Akubonakali ukuthi kunomthelela ekubhekaneni ne-lipoatrophy (ukulahlekelwa kwe-fat) ebusweni, emzimbeni noma emilenzeni, noma ukuqoqa amafutha emabeleni noma entanyeni.
I-Egrifta isebenza ngokugqugquzela i-pituitary gland ukukhulula i- hormone yokukhula komuntu (i-HGH) , umphumela wayo owaziwa ukukhuthaza i-lipolysis (okungukuthi, ukwehla kwe-lipids kanye ne-triglycerides).
Ucwaningo lubonise ukuthi ukwelashwa kwe-Egrifta kunganciphisa amafutha esiswini phakathi kuka-15% no-17% njengoba kulinganiswa nge-CT scan. Izilingo ezengeziwe ngo-2014 zibonise ukuthi i-Egrifta inganciphisa futhi amafutha anqwabelene nesibindi ngamaphesenti angu-18.
Isilinganiso Nokuphatha
Umthamo omdala omnconywa ka-Egrift ungama-2mg wegciwane ngaphansi kwesikhumba (ngaphansi kwesikhumba) kanye ngosuku. Kunconywa ukuba u-Egrifta abe nesilwane esiswini ngaphansi kwenkaba. Ukuguqula umjovo wesayithi ngokuvamile kusiza ukunciphisa ukonakala kanye / noma ukuqina kesikhumba.
I-egrifta ibuyiswa kabusha kusuka kwesinye sezidakamizwa zamanzi usebenzisa amanzi angenawo oyedwa, okugcina okuhlinzekwa kukhomba elihlukile ( elifanekiselwe ). Ngemva kokuvuselelwa kabusha, lesi sidakamizwa kumele sisetshenziswe ngokushesha. I-Egrifta engakhiwa kabusha kumele igcinwe esiqandisini phakathi kuka 36 o F no 46 o F (2 o C no 8 o C).
I-Egrifta ayiboniswa ukuphathwa kwesisindo.
Isikhathi kanye Nokuqapha Ukwelashwa
Njengoba imiphumela yesikhathi eside noma izinzuzo zokwelapha ezingaziwa zingaziwa ngokugcwele, kufanele kwenziwe yonke imizamo yokuqapha imiphumela yokwelapha ngendlela ye- CT scan noma izilinganiso zokulinganisa izikhonkwane. Uma isiguli singabonisi ukunciphisa kwalezi zindlela, kufanele kucatshangelwe ukuyeka ukwelapha.
Isikhathi sokwelapha kufanele ngaso sonke isikhathi sixoxisane ngokuqondile nongcweti we- HIV / AIDS otholakala ekwelashweni kwe-GHRH, noma ngokubonisana phakathi kochwepheshe we-HIV / AIDS kanye ne-endocrinologist eqeqeshiwe.
Amazinga e-glucose kufanele aphinde ahlolwe njalo ngesikhathi ukwelashwa ngoba u-Egrifta angabangela ukubekezelelana kwe-glucose kwabanye, ukubeka isiguli engozini enkulu yokuthuthukisa isifo sikashukela .
Imiphumela Ejwayelekile Yokwenzeka (okwenzeka okungenani iziguli ezingu-2%)
- Ubuhlungu obuhlangene (i-arthralgia)
- Ubuhlungu ezindaweni eziphelile
- Ubuhlungu besisu (myalgia)
- Injection site redness, ukuvuvukala noma ubuhlungu
- Ukuzwakala kwengqondo yesikhumba (i-paresthesia)
- Ukuphazamiseka okuyingxenye yesikhumba (hypoesthesia)
- Rash
- Ukuqhuma
- I-itching (pruritis)
- I-nausea
- Ukuvota
Ukusebenzisana kwezidakamizwa
I-Egrifta isebenzisana nalezi zidakamizwa ezilandelayo, ukwehliswa ukungenisa / ukulethwa kokubili kanye nesidakamizwa esilandelayo:
- Imithi yokwehla kwe-cholesterol: i-Zocor (i-simvastatin)
- Imithi yokwelapha i-HIV: Norvir (ritonavir)
Ukungafani nokucabangela
I-egrifta akufanele iwanikezwe kunoma ubani one- malignancy esebenzayo , noma esanda kutholakala noma ephindaphindiwe njenge-HGH ingathonya ukukhula kwezicubu zesisu (ukubola). Ukucabangela ngokucophelela kufanele kwenziwe ezigulini ezinezicubu ezingekho ezimbi noma labo abanomlando wezifo eziphathekayo noma ezizinzile, ezilinganisa izinzuzo ezingase zibhekane nezingozi ezingenzeka.
Ukuzifakaza kuqhathaniswa neziguli eziye zahlinzwa, isifo se-pituitary, i-hypopituitarism, i-head irradiation, noma ukususwa kokuhlinzwa kwe-pituitary gland (hypophysectomy).
I-Egrifta iphinde icatshangelwe kwabesifazane abakhulelwe abane-HIV njengezicubu ezibonakalayo zenzelwe ukwandisa ngesikhathi sokukhulelwa kanye nanoma yikuphi ukunciphisa ngendlela yokwelashwa kwe-GHRH kungalimaza ingane. Uma ukukhulelwa kwenzeka, yeka ukwelashwa kwe-Egrifta.
I-Egrifta ayiboniswa uma isiguli sinesifo esithile esaziwayo ku-tesamorelin noma i-Osmitrol (i-mannitol) yesisu esihamba phambili.
Ukucabangela ngokucophelela kufanele kwenziwe nalabo abanesifo sikashukela njengo-Egrifta abangakwazi ukwandisa amazinga e- insulin ukukhula 1 (IGF-1) . Ukuqapha okumele kwenziwe njalo kumele kubonwe ukuthuthukiswa noma ukuwohloka kwe- retinopathy yesifo sikashukela (ukulimala okuqhubekayo noma okunamandla kwe-retina).
Imithombo:
I-US Food and Drug Administration (FDA). "I-FDA ivumela u-Egrifta ukuthi aphathe i-Lipodystrophy kwiziguli ze-HIV." I-Silver Spring, e-Maryland; ukushicilelwa okukhishwe ngoNovemba 10, 2010.
Stanley, T .; I-Feldpausch, M .; O, J .; et al. "Imiphumela ye-tesamorelin ngamafutha asheshayo ezigulini ze-HIV: isilingo esilawulwa ngokungahleliwe, esilawulwa yi-placebo." Umagazini we-American Medical Association (JAMA). NgoJulayi 23-30, 2014; 312 (4): 380-389.