FDA I-Esbriet Yamukelekile Nje ne-Ofev ye-Idiopathic Pulmonary Fibrosis.
Ngo-Okthoba 2014, i-FDA ivume izidakamizwa ezimbili ezintsha, i-pirfenidone (Esbriet) ne-nintedanib (Ofev), ekwelapheni i-idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis yisifo esibuhlungu esibulala abantu abaningi abatholwa nayo eminyakeni embalwa embalwa. Ngaphambi kokutholakala kwe-pirfenidone ne-nintedanib, kwakungenakho ukwelashwa okuqondile kwezidakamizwa kubantu abanalesi sifo esibulalayo.
Iyini i-idiopathic Pulmonary Fibrosis?
Idiopathic pulmonary pulmonary isifo esingapheli noma eside esiqeda izikhala ezincane ngaphakathi kwamaphaphu (interstitia). Nakuba idatha elinganiselwe ikhona ngokusakazeka kwalesi sifo, i-American Lung Association ilinganisela ukuthi itshaya cishe abantu abangu-140 000 baseMelika. Ngenkathi ngisebenzisa izincwadi, ngabona izilinganiso eziphansi kakhulu lapho lesi sifo sichazwa ngokuthe xaxa (sicela uxhumane ne-pun), futhi sithinta noma yikuphi kusuka kubantu abangu-14 no-28 abangama-100,000. Abantu abanesifo ngokuvamile baneminyaka engama-50 ubudala nangaphezulu, futhi lesi sifo sithinta amadoda amaningi kunabesifazane.
Akekho owazi ukuthi yini ebangela i-idiopathic pulmonary fibrosis (yingakho ibizwa ngokuthi yi- idiopathic disorder). Lokho esikwaziyo ukuthi lesi sifo esibulalayo siyakhula siphumelele emaphashini-amaphaphu ayingxenye yokweqa-okwenza kube nzima ukuphefumula. Okuphawulayo, i-idiopathic pulmonary fibrosis iyisifo esithintekayo se-lungs esinciphisa imibala yamaphaphu.
Uma sekutholakala ukuthi, iminyaka yobudala yokuphila kwabantu abanesifo yile minyaka engama-4 kuphela.
Idiopathic pulmonary fibrosis ibangela ukuvuvukala kanye nezinguquko ze-fibrotic (ukucheka) emathangeni amaphaphu (parenchyma) okuxhunyaniswe nama-capillaire we-pulmonary e-alveoli. Ama-capillaire we-pulmonary e-alveoli abhujiswa kanjalo; Ama-capillary e-pulmonary abandakanyeka ekushintsheni kwe-oksijeni futhi azisa igazi elicebile oksijini emzimbeni.
Ngamanye amazwi, kubantu abano-fibrodium idiopathic pulmonary, ukuhluleka kwamapayipi amaphaphu kukhono lamapillazi we-pulmonary ukuhlunga umoya-mpilo emoyeni esiwuphefumulayo.
Idiopathic pulmonary fibrosis yenza kube nzima ukuphefumula emva kokuzama. Iphinde ibangele ukukhwehlela nokushintsha kwamapayipi emaphaphu ekuhlolweni. Izimpawu eziningi zalesi sifo ziyi-systemic noma umzimba wonke, futhi, futhi zihlanganisa ukukhathala, ukulahlekelwa isisindo kanye nokubhuka kweminwe nezinzwane. Izilinganiso eziphezulu ze-CT (cabanga nge-x-rays enemininingwane eningi) zikhombisa ukubonakala okuphazamisayo noma ukubonakala kwe-honeycomb lapho kwenzeka khona ushintsho lwe-fibrotic. I-biopsy yokuhlinzeka inikeza ukuxilongwa okucacile kwalesi sifo. Njengoba i-fibrosis ye-pulmonary iqhubeka, iholela esimweni semibandela ye-comorbid noma ehambisanayo kuhlanganise nokuhluleka kokuphefumula, ukwehluleka kwenhliziyo kanye nokucindezeleka komfutho wegazi .
Nakuba singaqiniseki ukuthi yini ngempela eyenza i-idiopathic pulmonary pulmonary, siyazi ukuthi kunezici ezithile eziyingozi zokugula:
- ukubhema ugwayi
- ama-viral lung infection
- ukungena kwegesi, imfucumfucu, uthuli nezinye izinhlayiyana ezincane
- I-GERD (isifo se-reflux se-gastroesophageal AKA esingapheliyo)
- izakhi zofuzo
Idiopathic pulmonary fibrosis iyaziwa ngokuntuleka kwayo kokwelapha okuhle nokuphumelelayo.
Nakuba abanye abantu behlala isikhathi eside kakhulu ngemva kokuxilongwa, kuningi kakhulu noma kuphuthumayo ngisho nangokwelashwa. Ukwelashwa kwamanje kuhloswe ngezibonakaliso zezifo noma ukuzama ukunciphisa ukuvuvukala okunye nokwehluleka. I-prednisone, i-steroid, ivame ukusetshenziswa ukusiza ukuvimbela ukuvuvukala. Abantu abaningi abane-fibrosis ye-idiopathic pulmonary futhi bathola ukwengeza okwenziwe oksijini kanye nokuvuselelwa kwamaphalenda. Ekugcineni, ukhetho olulodwa kuphela lwezokwelapha kubantu abane-idiopathic pulmonary pulsary is transplant.
Yini i-Pirfenidone (Esbriet) no-Nintedanib (Ofev)?
Ezilingo zomtholampilo, i-pirfenidone (Esbriet) ne-nintedanib (Ofev) iye yaboniswa ukunciphisa i-fibrosis noma inqamuzana, ngakho-ke ukuqhubekela phambili kancane kwesifo.
I-Pirfenidone inezinqubo eziningi ezenzekayo futhi iyimithi yomlomo. Esivivinyweni sesigaba sesi-3 somtholampilo, cishe isigamu sabathintekayo abane-fibrosis ye-idiopathic yamaphazamisi emnene etholakeleyo abayitholile i-pirfenidone babona ukwehla okunciphise emandleni okuphoqeleka okuphoqelekile. Lesi silinganiso sibonisa ukuqhubeka kokuphuza kwesifo. Abahlanganyeli babhekana nezinye izinzuzo ezihlanganisa ukuthuthukiswa ebangeni elihamba ngamaminithi angu-6 futhi kunciphisa ekufeni (inani lokufa) ngesikhathi sesifundo seviki ezingu-52. Imiphumela emibi engaba khona yokwelashwa yayingakwazi ukuphathwa futhi ikhawulwe ku-photosensitivity, izitho zomzimba zesisu, isicanucanu nokuhlanza.
I-Nintenanib i-tyrosine-kinase inhibitor kanye ne-pirfenidone yimithi yomlomo. Phakathi kwezinye izinqubo ze-biologic, i-tyrosine kinase ibandakanyeka ekuguqulweni kwesibindi kanye ne-fibrotic. Esivivinyweni sesigaba sesi-3 semitholampilo, njenge-pirfenidone, i-nintenanib nayo yanciphisa ukuqhubekela phambili kwe-fibrosis ye-idiopathic yamaphazamisi njengoba kulinganiswa ukunciphisa izinga lokuncipha kwenani elibalulekile lokuphoqeleka. Imiphumela emibi engase ibe yilezi zihlanganisa isifo sohudo, isicanucanu, ukuhlanza, ukukhanda ikhanda, ukwanda kwengcindezi yegazi, nokwandisa ama-enzyme yesibindi (isibonakaliso sokungasebenzi kwesibindi). Okokugcina, u-Ofev uyisifo esingafanele sithathwe ngesikhathi sokukhulelwa ngenxa yokwesaba ukubola kwesisu noma ukufa.
Yini i-Pirfenidone (Esbriet) no-Nintedanib (Ofev) Eshoyo Kuwe?
Uma wena noma umuntu owaziyo ene-fibrose ye-idiopathic pulmonary, ukuvunyelwa kwe-pirfenidone (Esbriet) ne-nintedanib (Ofev) Kuyinto impumelelo yangempela yezokwelapha okufanele ifakwe njengezindaba ezinhle. Kodwa-ke, ezinye izinkinga kudingeka zicaciswe ngaphambi kokuba lezi zidakamizwa zithole indawo yazo emithi yokwelashwa. Okokuqala, akucaci ukuthi i-pirfenidone ne-nintendanib kufanele isetshenziswe ngokwehlukana noma ngesikhathi esifanayo uma kuphathwa i-idiopathic pulmonary fibrosis. Uma sisetshenzisene ndawonye, asiqiniseki ukuthi yisiphi isidakamizwa okufanele sisetshenziswe kuqala. Uma sisetshenziselwa ngokwehlukana, asiqiniseki ukuthi imithi izobonisa umphumela noma umphumela ongathandwa. Okwesibili, asiqiniseki ukuthi abanye abantu basabela ngokukhethekile ("abaphenduli") kokunye noma kokubili kule mithi. Okwesithathu, asazi ukuthi izidakamizwa zizoqhubeka yini ukunciphisa ukuqhubekela phambili kwe-fibrosis ye-idiopathic yangaphambilini esikhathini esidlule sokuhlolwa.
Ngombhalo wokugcina, uma wena noma othandekayo ene-idiopathic pulmonary fibrosis, cabanga ngokufunda okwengeziwe ngamaqembu asekela lesi sifo ku-American Lung Association noma iNational Heart, Lung, ne-Blood Institute.
Imithombo ekhethiwe
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