I-FDA echongiweyo yokusetyenziswa kweziyobisi ekunciphiseni i-Gut Fat eqokelelweyo ngo-15-18%
Ukwahlula
I-Egrifta (tesamorelin) yindlela ejoyiweyo, yokwenziwa kwe-hormone-release hormone (GHRH) evunywe yi-US Food and Drug Administration (FDA) ngoNovemba 2010 ukwenzela unyango lwe -lipodystrophy enxulumene ne-HIV .
Ngokuphathelele i-Lipodystrophy ene-HIV
I-lipodystrophy enxulumene ne-HIV yimeko ebonakaliswe ngokuphindaphindiweyo ngokusasazeka kwamafutha omzimba.
Imeko ibonisa ngokugqithisa ngokucacileyo ubuso, iintambo, okanye iindawo eziphambili, ngelixa idla ngokubangela ukuba amanqatha aqokelele esiswini, amabele, okanye umva entanyeni (ekugqibeleni oku kuthiwa "yi-bhulo") ebonakalayo).
I-lipodystrophy enxulumene ne-HIV isoloko idibene kunye neentlobo zemithi yokulwa ne-antiretroviral , kuquka i- protease inhibitors (i-PIs) kunye nezinye i- nucleoside reverse transcriptors (NRTIs) njengeZerit (stavudine) kunye neVidex (didanosine). Le meko ingakhokelela ekusulelekeni kwintsholongwane kaGawulayo, ngokukodwa ekuchaphazela izigulane ezingekaqalanga unyango lwe-antiretroviral.
Nangona i-lipodystrophy ibonakala ingaphantsi kwabantu abanentsholongwane kaGawulayo ekubeni i-antiretrovirals yesizukulwana esandul 'ukutsha, yahlala ingxaki kuba imeko ayifumaneki kwakhona xa iyenzeka kwaye nangona amayeza enkcenkceshelo ayimisiwe.
Inkcazo Yonyango kunye neMiphumo
I-Egrifta iboniswe kwizigulane ezinegciwane le-HIV ngokuthe ngqo ukunciphisa amaninzi angama-visceral (oko kukuthi, i-fat ehlanganiswa kwisigxina esiswini kunye nakwamalungu angaphakathi).
Akubonakali ukuba nayiphi na impembelelo kwi-lipoatrophy (ukulahlekelwa kwetyekeleko) ebusweni, kwisithambiso okanye kwimilenze, okanye ukuqokelela amafutha kumabele okanye emqaleni.
U-Egrifta usebenza ngokukhuthaza i-pituitary gland ukukhulula i- hormone yokukhula komntu (i-HGH) , umphumo waloo owaziwayo ukukhuthaza ipolysile (oko kukuthi, ukuphulwa kwe lipids kunye ne-triglycerides).
Ucwaningo luye lwabonisa ukuba unyango lwe-Egrifta lunokunciphisa amafutha esiswini phakathi kwe-15% kunye ne-17% njengoko kulinganiswe nge-CT scan. Ulingo olongezelelweyo ngo-2014 luye lwabonisa ukuba i-Egrifta inokunciphisa i-fat accumulated around the liver by 18%.
Isistim nokuLawula
Umlinganiselo omdala ophakanyisiweyo we-Egrift u-2mg injected undercutaneously (phantsi kwesikhumba) kanye ngosuku. Kunconywa ukuba u-Egrifta angeniswe ngesisu esiswini. Iindawo ezijikelezayo zejoza zikunceda ukunciphisa ukonakala kunye / okanye ukuqina kolukhuni.
U-Egrifta uphinde wabuyiselwa kwisitya esisodwa seziyobisi usebenzisa amanzi angenanzi, ekugqibeleni oko kunikezelwa kwi-vial ehlukeneyo ( echazwe ). Emva kokuhlaziywa kwakhona, isiza kufuneka sisetyenziswe ngokukhawuleza. I-Egrifta engabonakaliyo kufuneka igcinwe kwiqrijini phakathi kwama-36 oF no-46 o F (2 oC no-8 oC).
I-Egrifta ayibonakaliswa ukulawulwa kwexabiso lokulahleka.
Ubude bexesha kunye noLiso lweNyango
Ekubeni iimiphumo zangexesha elide okanye iingeniso zonyango ezingaziwa ngokupheleleyo, zonke iinzame kufuneka zenziwe ukuba zibekwe iliso kwiziphumo zonyango ngendlela ye- CT scan okanye imilinganiselo yokulinganisa intshontsho. Ukuba isigulane singabonakali ukunciphisa ngokucacileyo kwezi ndlela, kufuneka kuqwalaselwe ukuyeka unyango.
Ubungakanani bonyango kufuneka benziwe rhoqo ngokubambisana ngqo kunye neengcali ze- HIV / AIDS ezijongene neli-GHRH, okanye ngokubonisana phakathi kweengcali ze-HIV / AIDS kunye ne-endocrinologist efanelekileyo.
Amazinga e-glucose kufuneka ahlolwe rhoqo ngexesha lolo lonyango ukususela ngo-Egrifta kungabangela ukunyamezelana kwe-glucose kwezinye, ukubeka isigulane ingozi enkulu yokuhlakulela isifo sikashukela .
Iziphumo eziqhelekileyo (ezenzeka kwizigulane ezi-2%)
- Intlungu ehlangeneyo (arthralgia)
- Ubuhlungu obuphelileyo
- Intlungu yesisu (myalgia)
- Ubunjani bomzimba obomvu, ukuvuvukala okanye intlungu
- Ukuvakalelwa kwesikhumba (paresthesia)
- Ubunxantathu bodwa besikhumba (u-hypoesthesia)
- Rash
- Ukuqhuma
- Ukutshiza (pruritis)
- I sizathu
- Ukuvutha
Ukusebenzisana kweziyobisi
U-Egrifta usebenzisana namachiza alandelayo, ekunciphiseni ukutshatyalaliswa / ukuhanjiswa kokubodwa kunye neziyobisi ezihamba kunye:
- Iyeza zokunciphisa i-Cholesterol: Zocor (simvastatin)
- Iyeza-antiretroviral ye-HIV: i- Norvir (ritonavir)
Ukungqinelana nokuqwalasela
I-Egrifta ayifanele iwanike nabani na ukunyanzelisa okusebenzayo , mhlawumbi ifunyaniswe okanye iphindaphinda njengeHGH inokuchaphazela ukukhula kweetiski (tumor). Ukuqwalasela ngenyameko kufuneka kwenziwe kwizigulane ezingenayo izihlamba ezingekho embi okanye abo baneembali zokuphathwa kakubi okanye ezizinzileyo, ezilingene nezibonelelo ezinokubakho ezinobungozi.
I-Egrifta iyaphikiswa kwizigulane eziye zahlinzwa, i-tumor pituitary, i-hypopituitarism, i-irradiation yekhanda, okanye ukutshatyalaliswa kokugonywa kwe-pituitary gland (hypophysectomy).
I-Egrifta iphinde ichazwe nakwabesetyhini abakhulelwe abane-HIV njengengxenyana ye-visceral kuthethwa ukwandisa ngexesha lokukhulelwa kunye naluphina ukunciphisa ngendlela ye-GHRH unyango lunokulimaza umntwana. Ukuba ukukhulelwa kwenzeka, yeka utywala lwe-Egrifta.
U-Egrifta awuboniswa ukuba isigulane sine-hypersensitivity eyaziwayo kwi-tesamorelin okanye i-Osmitrol (i-mannitol).
Ukuqwalaselwa ngenyameko kufuneka kwenzelwe abo abanesifo sikashukela njengoko i-Egrifta inokunyusa ukwanda kwe-insulin ye-1 (IGF-1) . Ukubeka esweni rhoqo kufuneka kwenziwe ukuba kuchongwe ukuphuhliswa okanye ukunyuka kwe- retinopathy yesifo sikashukela ( ukuphazamiseka okuqhubekayo okanye kwe-retina).
Imithombo:
US Administration and Drug Administration (FDA). "I-FDA iyavuma i-Egrifta ukuphatha i-Lipodystrophy kwizigulane ze-HIV." Silver Spring, eMaryn; ukukhutshwa kogcino ekhutshwa ngoNovemba 10, 2010.
Stanley, T; Feldpausch, M .; O, J; okqhubekayo. "Iimpembelelo ze-tesamorelin ngamafutha anesifo kwizonyango ze-HIV: ityala elingalawulwa ngokungaqhelekanga, elilawulwa yi-placebo." Umbhalo we-American Medical Association (JAMA). Julayi 23-30, 2014; 312 (4): 380-389.