Ayikho Yonke i-Biologics isebenza ngendlela efanayo Xa unyango lwe-IBD
Iklasi elitsha leziyobisi ezisetyenziselwa ukuphatha ukuvuvukala okubangelwa izifo zesibilini (inflammatory disease) (IBD) kuthiwa yi-biologics. Nangona kunjalo, olu luhlu olubanzi kakhulu lwamachiza, kwaye awona onke asebenza ngendlela efanayo okanye anikezelwa ngendlela efanayo. Abanye bavunywa ukuba baphathe uhlobo olulodwa lwe-IBD, ngelixa ezinye zisetyenziselwa ukunyanga kwesibini isifo sikaCrohn kunye ne-ulcerative colitis.
Ngenxa yokuba iziyobisi ze-biologic ziguqula umzimba wokuzikhusela ngeendlela ezahlukeneyo (ngesinye isizathu isizathu sokuba zisebenze i-IBD), abantu abazithathayo banokuba neengxaki zokufumana iintlobo zezifo. Kubalulekile ke ngoko ukuthatha amanyathelo ukuqinisekisa ukuba ukhuselo lukhona ukukhusela izifo. Abantu abane-IBD kufuneka bafumane ukugonywa , ngokufanelekileyo ngaphambi kokuba baqale i-biologic, kodwa amaninzi amaninzi anokunikwa xa bethatha i-biologic.
Ngaba oogqirha bakhetha ukuba yiphi i-agent biologic ukucebisa isiguli? Kukho iintlobo ezahlukileyo phakathi kwala mayeza, kwaye kukho izinto ezininzi ezithathwa ingqalelo. Oku kungabandakanya ukuphumelela (okuhlukahluka ngokusekelwe kwimiba yesifo kunye nesigaba), intengo, kunye ne-inshorensi, phakathi kwezinye izinto. Oogqirha baya kudinga ukuthatha yonke le miba ingqwalasela, nangaphezulu, xa wenza isiluleko kwisigulane kwiyeza ze-biologic.
Ngaphantsi kukhangelelaniso kwizinto ezimbalwa zezinto ezininzi zeemveliso zamachiza.
Izigulane kunye namagqirha baya kufuna ukulinganisela zonke ezi zinto kunye nabanye ngaphambi kokuba benze isigqibo.
Cimzia
I-Cimzia (certolizumab pegol) yi- tumor necrosis factor (TNF) blocker eyavunywa ngo-2008 ukunyangwa kwesifo sika-Crohn. Ngo-2009 kwavunyelwa ukunyanga i-rheumatoid arthritis, kunye ne-psoriatic arthritis kunye ne-spondylitis e-ankylosing ngo-2013.
I-Cimzia idla ngokunikezwa ngejoyi kunye nesirinji ekhethiweyo ekhaya. I-Cimzia inikezwa ngamagciwane amabini, okokuqala okulawulwe kwilasi yokulayisha kwiiveki 0, 2, no-4. Emva koko, iinjongo zombini zinikezelwa nganye kwiiveki ezi-4. Olunye uhlobo lweCimzia luyi-powder edibeneyo kwaye ifakwe kwiofisi yegqirha. Iziphumo eziphambili eziqhelekileyo ngokuqhelekileyo nale nkunkuma ziyizifo eziphambili zokuphefumula (njengobanda obubandayo), izifo zentsholongwane (njengentsholongwane), ukuxhatshazwa, kunye nezifo zogcino.
Amaphuzu aphambili malunga neCimzia:
- I-Cimzia ivunyelwe ukuphatha isifo sika-Crohn
- I-Cimzia ivame ukunikezwa ekhaya nge-injection
- I-Cimzia inikezwa ngokuphindwe kwezi-3 kwinqaku le-injections e-2, iiveki ezi-2 ngaphandle, zilandelwa zi-injections ezi-2 kwiiveki ezi-4
- Iziphumo eziqhelekileyo zibandakanya izifo zokuphefumula, izifo zintsholongwane, izifo ezixhatshazwayo, kunye nezifo zogcino
- I-Cimzia yiklasi ye-B yokukhulelwa
- Inani eliphantsi leCimzia lingadlulela kwisibele
- I-Cimzia idinga ukukhenkcezwa
Entyvio
I-Entyvio (vedolizumab) , eyavunywa ngoMeyi 2014, i-gut-homing α4β7 incinci. Kucingelwa ukuba kusebenze ngokubophezela ku-α4β7 integrin, okuvimbela ukuhlanganiswa ekubangela ukuvuvukala. I-Entyvio ivunyelwe ukusetyenziswa kubantu abadala abanesifo sikaCrohn okanye i-ulcerative colitis.
I-Entyvio isoloko inikezelwa ngokunyuswa, mhlawumbi kwiofisi yegqirha, esibhedlele, okanye kwiziko lokungena ngaphakathi. Ishedyuli yokulayisha ye-Entyvio i-3 infusions yenza iiveki ezimbini ngaphandle. Emva koko, i-infusions inikwa malunga neveki ezi-8. Ezinye zeempembelelo ezinobungozi zibandakanya ukukhulelwa komkhuhlane, umkhuhlane, intlungu, isisu, intlungu, ukukhathala, ukukhwehlela, intlungu, ukukhupha, ukukhuphaza, ukukhuphaza, ukunyuka, ukunyuka, ukunyanga kwesifo, intlungu yesisu, kunye nentlungu .
Amaphuzu aphambili malunga ne-Entyvio:
- I-Entyvio ivunyiwe ukuba i-ulcerative colitis nesifo sikaCrohn
- I-Entyvio inikezelwa ngokunyuka kumanani amathathu okuqala, kwaye emva kweeveki ezi-8
- Iziphumo eziqhelekileyo ezichaphazelayo zibandakanya izifo (ukubandayo, umkhuhlane, i-bronchitis, isifo sengqondo); intlungu kumalungu, emva, emqaleni okanye emaphethweni; iimpawu zentlungu, isifo somkhuhlane, ukukhathala, ukukhwehlela, okanye ukubetha; kunye nokukhawuleza
- I-Entyvio yiklasi ye-B yokukhulelwa
- Akwazanga okwangoku ukuba i-Entyvio idlulela kwibele
Humira
I-Humira (adalimumab) enye inkunkuma yomntu oyedwa kunye ne-TNF inhibitor esetyenziswa ekuphatheni abantu abane-IBD. Kuvunyiwe kubantu abadala kunye nabantwana abangaphezu kweminyaka engama-6 abanesifo sesilonda okanye isifo sikaCrohn. UHumira uqale wavunywa ngo-2002, waza wandisa ukwanda kwesifo sikaCrohn ngo-2007 kunye nesifo sezilonda zesilonda ngo-2012. I-Huma inokunikezwa ekhaya nge-injection. Izigulane ziqeqeshwe malunga nendlela yokuzinikela ngayo (okanye ingenziwa ngoncedo oluvela kulungu losapho okanye kumhlobo). Abanye abantu abane-Humira banakho ukubizwa ngokuba yi- reaction reaction site , evuvuka, intlungu, ukubetha okanye ukubomvu kwindawo apho ijojela ifakwe khona. Oku kunokwenzeka ukuba uphathwe ekhaya kunye neyeza okanye i-antihistamine amayeza (ukutshintsha ii-injection sites nganye iveki inceda kwakhona).
Amanqaku aphambili malunga neHuma:
- U-Humira uvunyiwe kwisifo sesibini sikaCrohn kunye nesifo sezilonda zesilonda
- UHumira unikezwa ekhaya nge-self-injection
- I-Huma iqaliswe ngamagciwane angama-4, ilandelwa ngamagciwane angama-2 emva kweveki kamva, kwaye emva kwe-1 injection nganye ngeveki
- Iziphumo eziqhelekileyo ziquka intlungu okanye ukucasula kwisayithi yokujova kunye nentloko, ukukhawuleza, kunye nesisulu
- UHumira iklasi ye-B yokukhulelwa
- Iintsana ezizalwe koomama ezithola i-Humira akufanele zifumane iigciwane eziphilayo kwiinyanga ezili-6
- IHumira idinga ukuba ifakwe efrijini
Ukukhupha
Iyeza lokuqala le-biologic elivunyelwe ukusetyenziswa kubantu abane-IBD yi- Remicade (i-infliximab) , eye yavunywa ngo-1998. Ukukhuphela i-antioclonal antibody eyenziwa yi-TNF inhibitor kwaye inikwe izigulane nge-IV. Oku kunokwenziwa kwiofisi yegqirha, kodwa ngokuqhelekileyo kubakho kwiziko le-infusion, ezizibonelelo ezizodwa ezilungiselelwe ukulawula unyango nge-IV. I-Remicade ingasetyenziselwa ukuphatha isifo sika-Crohn okanye isifo se-ulcerative colitis, kwaye savuma ukuba abantwana bancinane njengama-6, kwiimeko ezithile. I-Remicade icingelwa ukuba isebenze kubantu abane-IBD kuba inqanda i-TNF, nto leyo eyenza ukuvuvukala emzimbeni.
Amaphuzu aphambili malunga ne-Remicade:
- I-Remicade inikezwa ngu-IV
- I-Remicade ivunyiwe kwisifo sikaCrohn kunye ne-ulcerative colitis
- Izifo eziqala zokuqala zinikezwa (emva kwesazi yokuqala, okwesibini iiveki ezimbini emva koko, okwesithathu iiveki ezine emva koko)
- Emva kokuqala kwamanani, unikezelwa malunga neveki ezi-8 (ngezinye iixesha ngokukhawuleza xa kufuneka)
- Iziphumo eziqhelekileyo ziyintlungu yesisu, isicaphulelo, ukukhathala nokuhlanza
- I-Remicade yiklasi ye-B yokukhulelwa
- I-Remicade ayibonakali idlula ubisi lwebele
Simponi
I-Simponi (golimumab) i-TNF inhibitor evunyelwe ukunyanga i-ulcerative colitis. I-Simponi yavunywa kuqala ngowama-2009 ukunyanga i-rheumatoid arthritis, i-psoriatic arthritis, kunye ne- spondylitis e-ankylosing . Ngo-2013 kwavunyelwa ukunyanga i-ulcerative colitis. I-Ankylosing spondylitis yimeko enokuthi idibene ne-ulcerative colitis, oko kuthetha ukuba le nyeza ingasetyenziselwa ukuphathwa kokubili (okanye nayiphi) ingxaki. U-Simponi unikezelwa ekhaya, ngoko ke izigulane ziqeqeshwe ngumboneleli wezempilo ngendlela yokuzifaka ngokwazo (mhlawumbi ngokwabo okanye ngoncedo). Ezinye zeempembelelo ezimbi kwi-Simponi zifumana izifo ezibangelwa zizifo ezinjengomkhuhlane, iimpawu ezinjengomqala omzimba okanye i-laryngitis, kunye neentsholongwane zentsholongwane ezifana nomkhuhlane. Ukuba nobomvu, intlungu, kunye nokuchithwa kwiziko lokuxilisa, ngokuqhelekileyo unyango nge-ice kunye ne-antihistamines, yinto enye engasabela ngayo.
Amaphuzu aphambili nge-Simponi:
- I-Simponi ivunyiwe ukunyanga i-ulcerative colitis
- I-Simponi inikezwa ngejoza ekhaya
- I-Simponi iqalwa ngamagciwane angama-2, ilandelwa li-injection e-1 emva kweeveki ezilandelayo, kunye ne-injection e-1 nganye kwiiveki ezine emva koko
- Iziphumo eziqhelekileyo ziquka intlungu okanye ukucasula kwisayithi yokujova kunye nokukhupha okuphezulu okanye ukusuleleka kwintsholongwane
- Simponi luhlobo lwe-B lokukhulelwa kwesilwanyana
- Akwazanga okwangoku ukuba i-Simponi iyakuchaphazela njani umntwana osweleyo
- I-Simponi kufuneka ifakwe efrijini
Stelara
I-Stelara (ustekinumab) ngumntu ophilileyo ogciniweyo womntu oyimithi ye-immunoglobulin. Kwakuqala ukuvunyelwa ngo-2008 njengonyango lwe-psoriasis ye-plaque kwaye ngo-2016 ukuphatha isifo sika-Crohn. I-Stelara isebenza ukunciphisa ukuvuvukala kwesifo sikaCrohn esibangela ukujoliswa kwe-interleukin (IL) -12 kunye ne-IL-23, ekucingelwa ukuba ibambe indima ekuphuhliseni ukuvuvukala emathunjini. Inqanaba lokuqala likaSlara linikezelwa ngokunyuswa, kwindawo yokungena ngaphakathi okanye kwiofisi yegqirha. Emva kokuba okokuqala ukungena kwamandla, uStela uyakuthatyathwa ekhaya kunye nejoyiki enikwa iiveki ezi-8. Izigulana ziyakwazi ukuziphazamisa emva kokuqeqeshwa ngumboneleli wezempilo. Ezinye zeempembelelo eziqhelekileyo ezibonakalayo kubantu abanesifo sikaCrohn esithatha u-Stelara ziquka ukuhlanza (ngexesha lokungena kwamanzi kuqala), intlungu okanye ubomvu kwisayithi yokujola, ukutshiza, kunye nezifo ezifana nebandayo, isifo sovuba, i-bronchitis, i-urinary tract ukusuleleka, okanye isifo sosus.
Amaphuzu aphambili malunga noStelara:
- U-Stelara uvunyiwe ukuba aphathe isifo sikaCrohn
- Umthwalo wokulayisha we-Stelara unikezelwa ukunyuswa kwaye emva koko unikezwa ngamagciwane ekhaya
- Abantu abathatha izibhengezo zokunyamezela kufuneka bathethe noogqirha ngeendlela ezinokumelana nazo kunye noStelara
- Iziphumo eziqhelekileyo ezichaphazelekayo zibandakanya izifo, ukuphazamiseka kwesayithi kunye nokuhlanza
- I-Stelara yiklasi ye-B yokukhulelwa
- Kucingelwa ukuba uStela uyadlula kwi-breastmilk
- I-Stelara kufuneka ifakwe efrijini
> Imithombo:
> Janssen Biotech, Inc. "Inkqubo Yonyango Elula." Meyi 2013.
> Janssen, Inc. "I- Stelara (ustekinumab) Ukuchazela ulwazi ." Stelarainfo.com. Agasti 2016.
> Umama ukuya kumntwana. "I-Certolizumab Pegol (Cimzia) kunye nokukhulelwa." MotherToBaby.org. Agasti 2015.
> Takeda Pharmaceuticals, Inc. "malunga ne-Entyvio." Entyvio.com. 2015.
> UCB, Inc. "I- Cimzia (Certolizumab Pegol) Isikhokelo seMithi ." Cimzia.com. Matshi 2016.