I-Orencia (abatacept) yavunywa yi-US Food and Drug Administration (FDA) ngomhla wama-23 ku-2005, njengesixhobo sokugqibela sokunyanga iimpawu kunye neempawu zesifo se- rheumatoid arthritis . U-Orencia wajoyina ezinye i-DMARD ezintathu ze-biological ngexesha lokunciphisa ukuqhubela phambili komonakalo wesakhiwo, kubandakanywa nesifo se-tumor necrosis (izidakamizwa ezichasene ne-TNF):
I-Simponi (golimumab) neCimzia (certolizumab pegol), ii-blockers ze-TNF ezimbini, zavunywa kamva.
I-Orencia ivunyelwe ukuba yenzeke ngokukhawuleza kwizigulane ze-rheumatoid arthritis ezikhutheleyo ezinokuthi zineempendulo ezinganeleyo kwezidakamizwa eziguqula izifo (i-DMARD) ezongezelelekileyo kwiintsholongwane ze-TNF ziquka:
- Rheumatrex (methotrexate)
- Arava (i-leflunomide)
- Plaquenil (hydroxychloroquine)
- Azulfidine (sulfasalazine)
U-Orencia Ulawulwa njani
Ngokufanayo neRicicade (infliximab), i-Orencia inikezwa njenge-infusion (intravenous infusion) (IV). I-Orencia nakuba ilawulwa ngaphezu kwemizuzu engama-30, ngokungafani ne-infliximab elawulwa ngaphezu kweeyure ezingama-2.
Ukulandela ulawulo lokuqala, u-Orencia unikezelwa kwiiveki ezi-2 kunye ne-4, emva kweeveki ezine emva koko. I-Orencia ingasetyenziselwa njenge-monotherapy (yodwa) okanye idibene kunye nezinye i-DMARD ezingengabanikeli be-TNF ngenxa yengozi yokwanda kwezobisi kunye nentsebenziswano.
Ukususela ngoJulayi ka-2011, ukuqulunqwa kwe-Ojeria kwinto engaphantsi kwamanzi kuvunyiwe yi-FDA.
Iimpawu eziPhakathi ezixhatene no-Orencia
Iziphumo ezichaphazelekayo zibandakanya kodwa azithethi:
- iimpendulo ezithintekayo ezinokuthi zingasongela ubomi
- sulelo
- iingxaki zokuphefumula (ingakumbi kwizigulane ezinesifo esingasisigxina se-pulmonary disease and malignancies)
Amaqiniso Okuqwalasela Ngaphambi Kokuzama U-Orencia
Iindleko ze-Orencia kubandakanywa ukubeka iliso kuninzi kunokuba zichasene ne-TNF ezichasene ne-adalimumab kunye ne-etanercept kodwa ngaphantsi kwe-infliximab. U-Orencia ubonise inzuzo elula xa esetyenziselwa yodwa, ukuba ibhetele ngokubhekiselele kwenye i-DMARD njenge-methotrexate okanye abanye ukuphumeza iziphumo ezifanelekileyo.
Kuze kubekho amava angaphezulu klinikhi kunye no-Orencia, abanye oogqirha bayayigcina izigulane eziye zahluleka okungenani ezimbini kwiintetho zintathu ze-TNF (zilinganiswa yimiphumo engathandekiyo okanye ukungabi nzuzo). Ezi zi yobisi zonyango ziye zithengiswa kwimarike ekubeni i-etanercept yaziswa ngo-1999 kwaye ibonise umlinganiselo wokungenelwa kwengozi.
Orencia vs. Anakinra
I-Anakinra ayisoloko isetyenziselwa ukunyanga i-rheumatoid arthritis ngenxa yesidingo sayo seentsholongwane zemihla ngemihla kunye nenzuzo encinci xa kuthelekiswa nabalandeli be-TNF abavimba umsebenzi we-TNF (i-cytokine okanye umthunywa phakathi kweeseli). I-TNF yinkomfa enendima ephambili ekubangela ukuvuvukala nokulimala kwi-rheumatoid arthritis.
Iiseli ze-T nazo zidlala indima ekwenzeni izibonakaliso zekliniki neempawu zesifo se-rheumatoid arthritis. U-Orencia uvimba umqondiso kwigazi eliyimfuneko kwiiseli ze-T ukwenza umonakalo.
I-Kineret (anakinra) ibimbela i-cytokine IL-1 edlala indima emonakalweni kwithambo eyingxenye yesifo se-rheumatoid arthritis.
Impendulo eyanikwe nguScott J. Zashin, MD, uprofesa oncedisayo wezonyango kwiYunivesithi yaseTexas Southwestern Medical School, iCandelo leRheumatology, eDallas, eTexas. UDkt. Zashin naye uhamba noogqirha kwii-Hospital zasePresbyterian zaseDallas nasePlano. Ungumntu we-American College of Physicians kunye ne-American College of Rheumatology kunye nelungu le-American Medical Association.