I-Novantrone (i-mitoxantrone) kunye ne- Tysabri (natalizumab) zombini zisetyenziswa kwiimeko ezifanayo ukuphatha isifo se-sclerosis ezininzi- kubantu ababuhlungu ngokuphindaphindiweyo-ukuyeka i-multiple sclerosis (i-RRMS) okanye ukuqhubela phambili ukuphindaphinda i-sclerosis (PRMS). I-Novantrone iboniswe kwi-multiple sclerosis (SPMS) esecaleni, kunye neTysabri inokukunceda kwiimeko ze-SPMS apho izilonda ezisetyenziswayo ziyaqhubeka zibonisa kwi-MRIs, ngokunjalo.
Ayikho enye ye-MS yokuphambili.
Oku kuthetha ukuba abantu abaninzi abanolunye lweentlobo ze-MS banokukhetha ukwenza: iTysabri okanye iNovantrone. Nangona bekuya kuba kuhle ukuba umntu unomlinganiselo omkhulu weenzuzo ngaphezu komnye kuzo zonke iinkalo, akunjalo. Njengazo zonke izinto ezibonakalayo kunye ne-MS kubonakala ngathi, i-Tysabri ngokumelene nesinqumo seNovantrone isekelwe kwiqela lezinto ezinzima. Okukhethiweyo kufuneka kusekelwe kwizinto ezithandayo kunye nendlela yokuphila, isincomo sobugqirha kunye nokufikelela, kunye nezinye izinto ezifana neendleko, ukwesaba imiphumo ethile kunye neemfuno zokubeka esweni.
Kule nqaku, ndenze konke okusemandleni ukuba ndiqhathanise iTysabri noNovantrone kwicala ngecala kwiinkalo ezininzi zonyango endiyazi ukuba abantu banomdla kuzo. Makhe ndixelele ukuba ezi ziyobisi zichaneke ngendlela eyahlukileyo. , ngoko akunjalo nje ukuba isicatshulwa esinye senza umsebenzi "olungcono" - benza izinto ezahlukeneyo, kodwa ngenjongo efanayo yokunciphisa ukukhubazeka kokukhuba nokukhusela i-MS kwakhona.
I-Tysabri yintsholongwane ye-monoclonal ekhusela ezinye i-T-cell ukuba zingadluli umqobo wegazi-ngqondo, ngoxa i-Novantrone i-chemotherapy ekhusela umsebenzi we-immune.
Nazi ezinye izinto oza kuziqwalasela xa ukhetha kwakho:
Ukufikelela kweDktri kunye neZakhono zakho
Kuphela oogqirha ababhalisiweyo kunye neprogram yokubeka iliso banokumisela iTysabri.
Abantu abaninzi abagqirha abanalo ukufikelela kwiTysabri bagqiba ukutshintshela kwi-neurologist enokufikelela. Naliphina ugqirha unokumisela iNovantrone, nangona kunjalo, kucetyiswa ukuba kulawulwe ngugqirha onamava ekubekeni iliso nokunyamekela izigulane ezifumana i- chemotherapy yale ndawo.
Iimpawu eziPhezulu kunye noKhuseleko
Nangona iiprofayili zobungozi bobabili iTysabri kunye noNovantrone zihluke ngokupheleleyo, zibini zenza ingxaki yokuqala okanye ukwesaba kubantu abaninzi - iTysabri inembali ye-PML noNovantrone yi-chemotherapy. Nantsi ingqungquthela ekhutshwayo - i-Novantrone iyakwenza uzive unomdla we-yucky emva kokunyuswa kweentsuku ezimbalwa, kunye nezinto ezinjengokuhlanza / isicupunu, ukwanda komngcipheko wesifo kunye nesifo sokuphefumula, kwaye, ngokufanelekileyo, unokulahlekelwa zakho iinwele. Kwi-Tysabri, mhlawumbi ngeke uzive unzima kakhulu kwiintsuku ezilandelayo ukunyuswa, njengoko iimpembelelo eziqhelekileyo eziqhelekileyo ziyi-reaction reaction site, ukukhathala, iintloko kunye nentlungu edibeneyo. Isizathu sokwenza isigqibo sokuba abantu abaninzi banokuhla ukukhetha phakathi (1.2 per 10,000) mngcipheko we-PML kunye neTysabri ngokumalunga nomngcipheko we-leukemia (7.4 kwi-1,000) okanye umonakalo wentliziyo kunye noNovantrone.
Ukuphindaphinda
I-Tysabri ilawulwa nge-intravenously (nge-IV kwiziko lokungena ngaphakathi okanye kwiofisi yakho yogqirha) kanye ngenyanga.
I-Novantrone ilawulwa rhoqo ngeenyanga ezintathu.
Ukusetyenziswa kwexesha elide
I-Tysabri (ngeli nqanaba ngexesha) lingasetyenziswa ngonaphakade, nangona ukhuseleko lweziyobisi emva kweminyaka emibili yokusetyenziswa lungaziwa. I-Novantrone, ngakolunye uhlangothi, ingasetyenziselwa kuphela ukuya kwiminyaka emibili ukuya kwimithathu (i-10 okanye 11 iindleko ezipheleleyo) kwixesha lokuphila kwesigulane.
Impumelelo
Ukusebenza kweziyobisi kubonakala kukufana, kodwa kunzima ukuthelekisa ngokuthe ngqo, ngenxa yokungafani koyilo lokufunda. Kwisifundo seminyaka emi-2, xa kuthelekiswa ne-placebo, i-Novantrone iboniswe ukunciphisa inani lokuphindaphinda, lilonge ixesha phakathi kokuphindaphinda, kubonisa ukunciphisa ipesenti ezingama-61 ekudakaleni kokukwazi ukuhamba kwabafundi abathathi-nxaxheba kunye nokukhubazeka okungaphantsi kwegazi.
I-Tysabri ibonise ukunciphisa ama-68% ekubuyiseleni kwakhona kwiminyaka emibini, kunye nokunciphisa ukunyuka kokukhubazeka nokunciphisa inani lokuphindaphinda kwakhona.
Ukukhulelwa (Kwangoku kunye neKamva) kunye nokuNxiliswa
Abafazi abakhulelwe okanye abazama ukukhulelwa akufanele bathathe iTysabri okanye iNovantrone, kwaye akufanele kusetyenziswe ngabasetyhini abancancisayo. I-Tysabri ithathwa ngokuba "kwindawo yokukhulelwa iC," oko kuthetha ukuba kubangele inzakalo kwimfuyo kwizifundo zezilwanyana kodwa umphumo kubantu awunakwazi. I-Tysabri kufuneka imiswe ixesha elithile ngaphambi kokuzama ukukhulelwa (ngokuqhelekileyo enye ukuya kwiinyanga ezintathu; xubusha oku ngogqirha wakho). I-Novantrone ithathwa ngokuba "kwindawo yokukhulelwa kwiCandelo D," oko kuthetha ukuba kunokubangela ukuba ingozi yomntwana ifakwe kwindoda ekhulelwe. Abafazi bexesha lokubeletha bafuna iimvavanyo zokukhulelwa ngaphambi kokufumana umthamo ngamnye weNovantrone.
INGCACISO EBALULEKILEYO: Abanye abesifazana (5-30%) bagqiba ikhondo elipheleleyo likaNovantrone bangaze baqalise kwakhona ixesha labo kwaye bangenabungozi (abakwazi ukukhulelwa). Kubaluleke kakhulu ukuqwalasela oku kwenzeka xa uthatha isigqibo sokuba okanye ungasebenzisi iNovantrone kwaye uxoxe ngayo nomyeni wakho okanye iqabane lakho. Uphando olutshanje lubonisa ukuba ithuba lokusweleka kwamabhinqa linganciphisa ngokusetyenziswa kweyeza-hormone (izidakamizwa ze-estroprogestinic) ngethuba lonyango neNovantrone kwaye oku kufuneka kuxoxwe nodokotela wakho.
Solu-Medrol
I-Solu-Medrol, i-corticosteroid ene-intravenous esetyenziselwa ukunciphisa ubude kunye nobukhulu bokubuyela kwakhona, ngokuqhelekileyo ayikhuthazwa ngabantu abasebenzisa i-Tysabri ubuncinane inyanga ngaphambi okanye emva kwe-infusion yokugqibela, ngenxa yokunyuswa kwama-immunosuppression, nangona kukho oogqirha abaya kubeka umyalelo kwimeko yokuphindaphinda kwakhona kwaye ndivile ngezilingo ezilinganiselayo (125 ukuya ku-500 mg) enikezwe ngexesha elifanayo kunye ne-Tysabri infusion ekuncedeni ngeempembelelo ezincinci kwiTysabri. Ngakolunye uhlangothi, i-Solu-Medrol idlalwa ngexesha elifanayo kunye ne-Novantrone ukumnika kwaye inokunikezwa ngokukhululekile kwimeko yokuphindaphinda phakathi kwe-Novantrone infusions.
Ukubeka iliso
Ngaphambi kokuba uqalise uNvantrone, uza kuthatha iilingo ezilandelayo: iimvavanyo zegazi (i-CBC, umsebenzi wesibindi, ukukhulelwa kwabasetyhini), i-electrocardiogram (EKG), kunye ne-echocardiogram njengolu vavanyo olusisiseko lweqhekeza le-ejection ye-ejection (LVEF) kufuneka lenziwe ngaphambi kokuba yonke idosi Novantrone. Ukunyangwa kwe-Novantrone kufuneka kupheliswe xa i-LVEF ishintsha kakhulu okanye iphantsi kwe-50%. Zonke iimvavanyo ziya kuphinda ziphindwe ngaphambi kokuba unyango ngamnye. I-Tysabri inokwenziwa kuphela kwiziko lokungena ngaphakathi elibhaliswe kwi-"TOUCH" program. "UKUBA" kumela "iTysabri Outreach: Ukuzibophezela okuManyeneyo kwizeMpilo" kwaye yinkqubo eye yafakwa kwindawo yokuzama ukubamba naziphi na iziganeko ezinokwenzeka ze-PML kumazinga okuqala, kunye nokuzikhusela. Uya kuhlolwa ngugqirha okanye umongika uze ufumane i-MRI ngaphambi kokuqala i-Tysabri, kwaye uvavanya zonke iinyanga ezi-3 ukuya kwezi-6 ngeenguqu ze-neurologic. Uya kucelwa ukuba uhlolisise ulwazi lwekhuseleko lomguli kwaye uzalise uphando olutshanje ngaphambi kokunyuswa kwamanye.
Ukungqinelana
I-Novantrone ayifanele isetyenziswe ngabantu abanesifo senhliziyo okanye ukuthatha amanye amayeza angonakalisa intliziyo, iingxaki zesibindi, izibalo ezibomvu kunye negazi elimhlophe, iingxaki zokuqhawula ngegazi, umhlaza okanye imbali yonyango lomhlaza ogqithisiweyo. I-Tysabri ayifanele ithathwe ngabantu abathatha i-immunosuppressants okanye i-immunomodulator okanye ngabantu abaneenkqubo zokuzivikela ezikhuselweyo. Akukho nonyango kufuneka ithathwe ngabantu abanezifo ezikhoyo.
Iindleko
I-Tysabri yenye yezona zonyango ezithengayo ze-MS ezikhoyo, kwi $ 28,400 ngonyaka ngeTysabri ngokwayo. I-Novantrone ixabisa malunga ne-3,000 yee-year ngemithi, eyenza ibe yindleko. Bobabini beza neendleko ezongezelelweyo kwiziko lokungena ngaphakathi.
Okukwintsusa
Isigqibo sokusebenzisa i-Tysabri okanye i-Novantrone ngumntu onobuqu, enokuba yinto elula okanye eyinkimbinkimbi, kuxhomekeke kwiziphi izinto ogxila kuzo okanye ezisebenza kuwe (umzekelo, umntu omele ahlawule ephaketheni angafumana iNovantrone ngaphezulu ekhangayo, ngelixa umfazi oselula ofuna abantwana kwikamva angancika kakhulu kwiTysabri). Ukuba ugqirha wakho unombono onamandla kakhulu ngendlela enye, qiniseka ukuba umcela ukuba achaze izizathu. Soloko uziva ukhululekile ukufumana enye imbono ukuba awuyikho. Kungenzeka ukuba ugqirha wakho akanako ukufikelela eTysabri - ukuba ufuna, fumana elinye ugqirha owenzayo kwaye abuze uluvo lwakhe. Ngokwahlukileyo, mhlawumbi ukuba ugqirha wakho akanakulungeleka ukusebenzisa iziyobisi zamakhemikhali, kodwa baninzi abanye oogqirha abaye basebenzisa iNovantrone kwikhulu lezigulane ezineziphumo ezinkulu. Qhubeka ufuna iimpendulo uze uyanelisekile.
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