Ulwahlulo oluphambili kwi-Efficacy, Indleko, noLawulo
I-TNF inhibitors (eyaziwa nangokuthi yi-TNF blockers) yiklasi yezilwanyana ezinokunciphisa ukuvuvukala ngokunyusa ukuphendula komzimba. Zisetyenziselwa ukunyanga iintlobo zeengxaki ezizimelayo eziquka i- rheumatoid arthritis (RA) , i-psoriasis, i-psoriatic arthritis, i-ulcerative colitis, nesifo sika-Crohn.
Ezi zintathu ze-TNF ezithandwayo kakhulu ezisetyenziselwa ukuphatha i-RA zi:
Nangona zonke iziyobisi zintathu zithintela impendulo yomzimba kwi-tumor necrosis factor (TNF) -ahlobo lweprotheni, olubizwa ngokuba yi- cytokine . nto leyo eyenza ukuvuvukala-nganye inokwakhiwa kweekhemikhali ezahlukeneyo kunye neenzuzo ezithile kunye nokunciphisa.
Indlela i-TNF Inhibitors esebenza ngayo
Ii-inhibitors ze-TNF zihlobo lweziyobisi ze- biologic ezisetyenziselwa ukuphatha izifo ezizimele njenge-RA. Ngoxa zijolise ngqo kwi-TNF, ezinye i-cytokines ezijoliswe kwi-cytokines ezifana ne-interleukin okanye zitshintshela indlela amaseli omzimba omzimba (abizwa ngokuba yi-T-cell okanye i-cell-cell).
Ii-inhibitors ze-TNF ziye zaba zixhobo ezibaluleke kakhulu ekulawuleni naseyonyango lwe-RA ukususela ekuqaleni kwawo ngo-1998. Ziyasebenza kwimpumelelo engaphezu kwama-70 ekhulwini abantu abaphila nesi sifo, kubandakanywa nalabo abangazange baphendule kwindlela yokwelapha ye-methotrexate yokuqala.
Xa zisetyenziselwa ukudibanisa ne-methotrexate, i-TNF inhibitors iyaziwa ukuba isebenze ngakumbi ekubuyiseni umgangatho wobomi be-RA abagulayo, ngokuphindaphindiweyo ngeeveki ezili-12.
Ulwahlulo kuLawulo
Ngoxa i-action ye-action ininzi okanye ingaphantsi kwayo yonke imithi emithathu, i-Enbrel, i-Huma, ne-Remicade inenani leenkalo eziphambili. Oyintloko phakathi kwabo kukulawulwa kweziyobisi kunye nokuphindaphinda kwe-dosing.
Nangona kukho ukuhluka kweendlela ezisetyenziswa ngayo iziyobisi, ngokuqhelekileyo zichazwe ngolu hlobo lulandelayo:
- I-Enbrel inikezelwa ngunxilongwane ongaphantsi (kwesikhumba) kanye kanye okanye kabini ngeveki.
- I-Humira ihanjiswa ngumjovo ongaphantsi kwinye iveki.
- I-Remicade idinga ukunyuswa kwe - intravenous rhoqo kwiiveki ezine ukuya kwezi-ezisibhozo.
Ngaphezu koko, ngokungafani neRicicade, i-Enbrel kunye neHuma inokulawulwa ngokwawo ngumlinganiselo olawulwayo. ipeni ejoyiweyo (njengaleyo esetyenziswa ngabantu abanesifo sikashukela ukuba bajobe i-insulin).
Ukwahlukana koLwazi
Enye indlela apho izidakamizwa zihluke ngayo ngethuba eliphakathi lokusebenza, oku kuthetha ukuba isixa sithuba ongasisebenzisa ngaphambi kokuba ufune ukutshintsha unyango.
Kule nto, ukuqhutywa kovavanyo ngo-2013 yizenzululwazi kwiYunivesithi yaseValladolid eSpeyin kuphande ixesha lokunyanga kwe-Enbrel, iHuma kunye neRicicade kubantu abangama-91 abane-RA.
Into abayifumene kukuba i-Enbrel kunye neHuma yayinexesha elide lokusebenza ngempumelelo ngaphezu kweminyaka eyisixhenxe (iintsuku ezingama-2,561 kunye neentsuku ezingama-2,769, ngokulandelanayo). Ngokuthelekiswa, i-Remicade yayinexesha eliqhelekileyo lokonyango elingaphezu kweminyaka emihlanu (iintsuku eziyi-1,853).
Kwimithi emithathu, u-Enbrel wabonisa ixesha elide lokusebenza, ikakhulukazi kwabasetyhini abahlala emanyeni kwiminyaka engama-9 (iintsuku ezingama-3,191). Ngaphezu koko, abantu asebekhulile kwi-Enbrel babengenako ukutshintsha kwenye i-TNF biologic.
Ngelixa izigqibo ziphelelwe ngolu hlobo lwesifundo, abaphandi baphetha ukuba, kwi-TNF inhibitors emithathu, i-Enbrel ibonise ukuphakama okucacileyo.
Ukungafani kwiindleko
I-TNF inhibitors zonke zibiza kakhulu xa kuthelekiswa nezinye izidakamizwa ze-RA, imbambano echaphazelekayo kunyango lwakho.
Nangona ukufumaneka kwezidakamizwa kunokuphuculwa emva kokufaka imali kwiintlawulo zentlawulo yomshuwalense, izaphulelo zentengiso kunye neenkqubo zokuncedisa isigulane, unokulindela ukuba inani elipheleleyo liwele ngaphantsi kwezi zigaba:
- Iindleko zeHuma ziphakathi kwama-1,800 kunye ne-$ 2,400 ngenyanga.
- I-Enbrel imitha engaphezu kwama-4,000 ngenyanga.
- Ingozi enye yeRicicade inokuhlawula i-$ 1,250 ukuya kwii-2,500 zama-$, kuye kuxhomekeke ekubeni ufuna ukudubula rhoqo kwiiveki ezine okanye kwiiveki ezisibhozo.
Nge-Remicade, kubalulekile ukubaluleka kwiindleko zokunyuswa kwebhedlele. Ngokwahlukileyo, u-Enbrel noHumira abazange bafumane ezi ndleko xa unquma ukuzifaka.
Ekugqibeleni, iindleko zonyango zonyango ziya kuxhomekeka kwi-inshorensi yakho kunye nokufaneleka kwakho kwintlawulo yentlawulo-ntlawulo njengoko kunikwa ngabavelisi be-Enbrel, iHuma kunye ne-Remicade.
> Umthombo:
> Martinez-Santana, V; Gonzalez-Sarmiento, E .; Calleja-Hernandez, M. et al. "Ukuthelekiswa kwamazinga okusinda kwezidakamizwa zesifo se-tumor necrosis ezichasayo kwi-rheumatoid arthritis." Umonde ukhetha ukunyaniseka . 2013; 7: 719-27. INGXELO: 10.2147 / PPA.S47453.