Ukudibanisa iziyobisi iziDakamizwa eziPhakamileyo eziPhakamileyo zeChirotype 1 kunye no-4
Ukwahlula
I-Zepatier (elbasvir / grazoprevir) yinyango edibeneyo isilwanyana esisetyenzisiweyo kunyango lwe- hepatitis C (HCV) engapheliyo. Amachiza amabini aquka i-Zepatier (elbasvir, i-grazoprevir) isebenza ngokuthintela iiprotheyini (NS5a) kunye ne-enzyme (NS3 / 4a protease) ibalulekile ekuphindaphindiwe kwintsholongwane.
I-Zepatier yavunywa ngoJanuwari 28, 2016 yi-US Food and Drug Administration (FDA) ekusebenziseni abantu abadala kweminyaka engama-18 okanye ngaphezulu kunye ne- HCV ye-genotype 1 okanye yesifo se-4 , kubandakanywa ne-cirrhosis.
Kuvunyiwe ukuba kusetyenziswe kuzo zombini ezingakhange ziphathwe (unyango-naïve) okanye izigulane zonyango (ngaphambili-zonyango), kuxhomekeke kwi-genotype ye-HCV kunye nemo yonyango.
Ukusebenza
I-Zepatier ibikwa ukuba inezinga eliphezulu lokunyanga kwiSigaba II sezilingo zabantu. Ukunyanga kwe-HCV kuchazwa njengokuba kugcinwe umthwalo wentsholongwane engabonakaliyo kwiiveki ezingama-24 emva kokugqitywa kweyeza (eyaziwa ngokuba yi- virologic response, okanye i-SVR ).
Izinga elipheleleyo le-SVR lisuka kuma-94% ukuya ku-97% kwizigulane ezine-HCV ye-genotype 1, xa izigulane ezineentsholongwane ze-genotype 4 zabikwa ukuba zinezinga le-SVR lika-97% ukuya kwi-100%.
Isistim
Elinye ipilisi (50mg / 100mg) ithathwa imihla ngemihla kunye okanye ngaphandle kokutya. Iipilisi ze-Zepatier zenziwe nge-oval-shaped, color beige kunye nefilimu, ene "770" emacaleni kwelinye icala.
Ukucetyiswa kweengcebiso
I-Zepatier imiselweyo okanye ngaphandle kwe ribavirin kwi-genotype 1 okanye 4 ukusuleleka. Ngokungafani neendlela zangaphambili ze-HCV, i- peginterferon (isilwanyana esinxulumene nesiphumo esingaxhaswanga ngaso sonke isikhathi ) ayimfuneko.
Ngaphambi kokuqaliswa kweyeza, ukuhlolwa kofuzo kungenziwa ukwenzela ukuba unqume ukuba unalo uhlobo lwegciwane elingagxininisi kwi-elbasvir yeZefatier (eyaziwa ngokuba yi-NS5a-resistant polymorphism).
Ixesha lexesha lezonyango zivela kwiiveki ezili-12 ukuya kwe-16, kuxhomekeke kwi-genotype ye-HCV kunye nemo yonyango.
| Genotype | Imozulu yonyango | Kuthathwe kunye ribavirin? | Ubude |
| Genotype 1a | unyango-naïve ngaphandle kwe- elbasvir intsholongwane | hayi | Iiveki ezili-12 |
| unyango-naïve kunye ne- elbasvir engaxhomekiyo intsholongwane | ewe | Iiveki ezili-16 | |
| waphathwa ngaphambili nge ribavirin + i-peginterferon ngaphandle kwintsholongwane ye-elbasvir | hayi | Iiveki ezili-12 | |
| waphathwa ngaphambili nge ribavirin + i-peginterferon kunye ne -virus ye-elbasvir engaxhatshazwayo | ewe | Iiveki ezili-16 | |
| waphathwa ngaphambili nge ribavirin + peginterferon + i-HCV protease inhibitor | ewe | Iiveki ezili-12 | |
| Genotype 1b | unyango-naïve | hayi | Iiveki ezili-12 |
| waphathwa ngaphambili nge ribavirin + peginterferon | hayi | Iiveki ezili-12 | |
| waphathwa ngaphambili nge ribavirin + peginterferon + i-HCV protease inhibitor * | ewe | Iiveki ezili-12 | |
| Genotype 4 | unyango-naïve | hayi | Iiveki ezili-12 |
| waphathwa ngaphambili nge ribavirin + peginterferon | ewe | Iiveki ezili-16 |
* - I- Olysio (simeprevir), i-Victrelis (boceprevir), i-Incivek (telaprevir)
Iziphumo eziPhakathi
Iziphumo eziqhelekileyo ezichaphazelekayo nokusetyenziswa kweZefatier (ezenzeka kwizigulane ezingama-5%) zi:
- Ukukhathala
- Intloko
- I sizathu
Xa isetyenziswe ne-ribavirin, iziphumo ezibi kakhulu zonyango (ezivela kwizigulane ezingama-5%) ziquka:
- Intloko
- Ukukhathala
- IAnemia
- I sizathu
- Ukucoca
- Ukunyanzelisa
- Ukuqhawukelwa ngumphefumlo
- Ukungabikho
- Ubuhlungu besisu
- Ukunciphisa ukutya
- Isiqhamo
- Ukutshatyalaliswa
- Rash
Ukusebenzisana kweziyobisi
La mayeza alandelayo angasetyenziswanga xa ethatha i-Zepatier njengoko zingabangela ukusebenzisana okukhulu kweziyobisi
- Antibiotics: nafcillin
- I-Anticonvulsives: i-Dilantin (i-phenytoin), i-Tegretol (i-carbamazepine)
- Iimpawu zokufakelwa: Iipilisi zomlomo zikaNizz (ketoconazole)
- Iziyobisi ezikhuselekileyo ezikhuselekileyo: I-Tracleer (bosentan)
- Iimveliso zamathambo: iSt. John's Wort
- Izidakamizwa ze-antiretroviral ze-HIV: i- Aptivus (tipranavir), i- Genvoya (elvitegravir, i-cobicistat, emtricitabine, i-tenofovir alafenamide), i- Intelence (etravirine), i- Invirase (saquinavir), i- Kaletra (i-lopinavir, i-ritonavir), i- Prezista (i-darunavir), i- Reyataz (atazanvir), i- Stribild ( i-elvitegravir, i-cobicistat, i-emtricitabine, i-tenofovir disproxil), uSustiva (efavirenz),
- Izidakamizwa ezingenasisifo esetyenziswayo ukukhusela ukutshintshwa kwezityalo: i-cyclosporine
- Iziyobisi ezisekelwe kwi-Rifampin ezisetyenziselwa unyango lwesifo sofuba: i-Mycobutin, i-Priftin, iRifater, i-Rifamate, i-Rimactane, i- Rifadin
Ingqwalasela yonyango
Kuye kwaxelwa kwiphando lwezonyango ukuba i-1% yezigulane kwi-Zepatier zakhuphuke kakhulu kwi-enzyme yesibindi ebonisa ubunobuthi besibindi, ngokubanzi okanye emva kweveki yesibhozo yonyango. Ngaloo ndlela, iimvavanyo zegazi ezinxulumene nesibindi kufuneka zenziwe ngaphambi kokuba kuqaliswe unyango rhoqo rhoqo ngexesha le-HCV.
I-Zepatier ayifanele ibekwe kwiigulane ezinobungozi obukhulu besibindi.
Ukusetyenziswa kwe-ribavirin kuyaphikisana nokukhulelwa kwaye akufanele kubekwe ngu-Zepatier okanye nayiphi na into echaphazelekayo ye-hepatitis C. Izigulane zezilwanyana kwi-ribavirin zonyango kufuneka zicetyiswe ukuba ziphephe ukukhulelwa kwaye zisebenzise ubuncinane iindlela ezimbini ezingekho-hormonal zokukhulelwa kwexesha ngexesha leyeza kunye neenyanga ezintandathu emva kokugqitywa kweyeza.
Umthombo:
US Administration and Drug Administration (FDA). "I-FDA iyavuma i-Zepatier ukwenzela unyango lwe-hepatitis C engapheliyo kunye no-4." Silver Spring, eMaryn; ukukhutshwa kwenkxaso ekhutshwe ngoJanuwari 28, 2016.
Merck. "I-Zepatier - eziphambili ze-Information Information." Kenilworth, eNew Jersey; fi kelele ngoJanuwari 29, 2016.