I-Interferon yisidakamizwa esilinganisa amaprotheni emzimbeni ukuthi amasosha omzimba asetshenziselwa ukubhubhisa amagciwane. I-interferon ye-Pegylated ifomu eliguquguqukile lomuthi okwazi ukuhlala emzimbeni isikhathi eside, okuhlinzeka ngemithi engcono. I-Polyethylene glycol (PEG) yengezwe kwi-interferon, inqubo ebizwa ngokuthi i-pegylation, esetshenziselwa nezinye izinhlobo zezidakamizwa kanye.
Izinhlobo ezimbili ze-interferon e-pegylated ziyatholakala futhi zisetshenziselwa ukwelapha ukutheleleka kwegciwane le- Hepatitis C.
- I-Peginterferon alfa-2a: Futhi ibizwa ngokuthi i-alfa-2a, igama lebhizinisi elithi Pegasys.
- I-Peginterferon alfa-2b: Futhi ibizwa ngokuthi i-alfa-2b, igama lebhizinisi elithi PegIntron.
Babecatshangwa ukuthi ukwelashwa okukhethile, okusetshenziselwa i-ribavirin, futhi kubalwe ohlwini lwaMithi Yezobuchwepheshe EzinguMpilo. Ukwelashwa kwe-HCV kuyashintsha ngokuvunywa kweSofosbuvir (Sovaldi) no-Simeprevir (Olysio) ngo-2013 yi-FDA. Le mithi emisha kanye nabanye okuqinisekisiwe ukulandela ingasusa ama-peginterferons njengokwelashwa okuthandwayo.
Umehluko omkhulu phakathi kwalezi zi-interferons ezimbili ze-pegylated usemalini. I-Alfa-2a isetshenziselwa umthamo weviki ohleliwe. I-Alfa-2b isetshenziselwa umthamo wamasonto onke ngesisindo sesiguli. Kukhona umehluko phakathi kwezidakamizwa ezimbili, kodwa ikakhulukazi ezobuchwepheshe futhi zisetshenziselwa udokotela odokotela .
Isibonelo, i-alfa-2a ine-absorption njalo njalo ngemva kwejoza futhi isakazwa ikakhulukazi egazini nasezigumbini. Kodwa i-alfa-2b ine-absorption okusheshayo nokusabalalisa kabanzi emzimbeni.
Umehluko Ekusebenzeni
Kuze kube ngoJanuwari 2008, akukho datha ngqo eliqhathanisa le mithi emibili. Lokho kushintshile ngokutadisha okukhulu okwenziwa emtholampilo obizwa ngokuthi i-IDEAL nokunye okufaniswa kwemitholampilo.
Lezi zihlinzeka ngemiphumela ezithakazelisayo ezizovumela odokotela ukuba baqonde ngokwengeziwe kulezi zindlela zokwelashwa ezingapheliyo zesifo se- hepatitis C.
Ucwaningo lwe-IDEAL - Ukuzikhandla Kwe-Dose Efficacy ngokubhekiselele ku-Flat Dosing Ukuhlola Ukwelashwa Okuphakathi Kwe-Interferon Ephakathi Ne-Optimal Pegylated Therapy - kuhilele abantu abangu-3070 ekulingweni okulawulwa ngokungahleliwe. Ithole ukusebenza okufanayo phakathi kwe-alfa-2a ne-alfa-2b ngokulinganisa okuqhubekayo kwe-virological response . I-Alfa-2a inenani lika-41% ne-alfa-2b ene-SVR ye-39%.
Kodwa icala alivaliwe. Ucwaningo olwengeziwe olwengeziwe lwathola umehluko obala phakathi kwezidakamizwa ezimbili, ne-alfa-2a ngokuwina ngokucacile ngamanani angaphezulu kwama-12% ama-SVR.
Ukuhlaziywa okuqhubekayo kweziguli ezingu-3518 ezivela ezilingo eziyisikhombisa ezilawulwa ngokungahleliwe kwathola imiphumela engcono nge-alfa-2a, nakuba iveza izinga eliphezulu le-neutropenia. I-neutropenia ukunciphisa inani lamaseli amhlophe egazi. Lena umphumela ohlangothini ongathandeki, njengamangqamuzana egazi ezimhlophe yingxenye enkulu yesistimu yomzimba yomzimba. Uma kunciphisa, uzobe usengozini yokutheleleka futhi ungakwazi ukulwa namabhaktheriya namagciwane.
Lezi ziphumo zizocatshangelwa uma kunconywa ukwelashwa. Kodwa izindlela zokwelapha ezintsha zingasusa ama-peginterferons njengendlela yokwelashwa kwesifo sofuba esingapheli.
Kunjalo uhlobo lokucwaninga nokuthuthukiswa. Kungase kube sekugcineni ukuziqhathanisa ukuqhathanisa lezi zidakamizwa ezimbili njengezokwelapha ezintsha.
Imithombo:
I-Berenguer M, i-Wright TL. I-hepatitis C. Ku: M Feldman, uLS Friedman, uLJ Brandt (eds), Izifo zamathumbu kanye nesifo senhliziyo, 8e . Philadelphia, Elsevier, 2006. 1701.
Imibuzo ye-Hepatitis C yabaSebenzi bezeMpilo, ngo-Oktoba 14, 2015. Izikhungo zokuLawula nokuvimbela izifo
McHutchison JG, Lawitz EJ, Shiffman ML, Muir AJ, Galler GW, McCone J, Nyberg LM, Lee WM, Ghalib RH, Schiff ER, Galati JS, Bacon BR, Davis MN, Mukhopadhyay P, Koury K, Noviello S, Pedicone LD , I-Brass CA, i-Albrecht JK, i-Sulkowski MS, i-IDEAL Ithimba Lokufunda. I-Peginterferon alfa-2b noma i-alfa-2a ne-ribavirin yokwelapha ukutheleleka kwe-hepatitis C. N Engl J Med. 2009; 361 (6): 580-93.
Rumi MG, Aghemo A, Prati GM, D'Ambrosio R, Donato MF, Soffredini R, Del Ninno E, Russo A, Colombo M. Ucwaningo olwenziwa nge-peginterferon-alpha2a plus ribavirin vs peginterferon-alpha2b plus ribavirin ku-hepatitis C. engapheli C. I- Gastroenterology . 2010; 138 (1): 108-15.
U-Ascione A, De Luca M, Tartaglione MT, Lampasi F, Di Costanzo GG, Lanza AG, Picciotto FP, Marino-Marsilia G, Fontanella L, Leandro G. Peginterferon alfa-2a plus ribavirin iyasebenza kakhulu kune-peginterferon alfa-2b plus ribavirin yokuphatha igciwane lesandulela ngculaza elingapheli. I-Gastroenterology . 2010; 138 (1): 116-22.
Alavian SM, Behnava B, Tabatabaei SV. Ukuphumelela kokuqhathanisa nokuphepha kwe-peginterferon alpha-2a vs 2b ekwelapheni ukutheleleka okungapheli kwe-HCV: ukuhlaziywa kwemeta. Hepat Mon. 2010; 10 (2): 121-31.