Izidakamizwa zeBioologic Not Equal Effective for Individual Patient
I-TNF (i-tumor necrosis factor) i-blockers yaba yinkqubo yokonyango kwizigulane ezine- rheumatoid arthritis okanye uhlobo oluthile lokuvuvukala kwe-arthritis ukususela ngowama-1998 xa i- Enbrel (etanercept) ivunyiwe yi-FDA. Ezinye iziyobisi ze-biologic ziye zavunywa kwaye zithengiswa.
I-TNF blockers iquka, i-Enbrel (etanercept), i- Remicade (i-infliximab), i- Humira (adalimumab), i- Simponi (golimumab) ne- Cimzia (certolizumab pegol).
Kukho ezinye iziyobisi ze-biologic, ezifana ne- Orencia (abatacept), iRituxan (rituximab), i- Actemra (tocilizumab), ne- Kineret (anakinra) engakhange ijolise kwi-TNF.
Ukuba uphathwe nge-blocker ye-TNF, kunokufuneka ukuba utshintshe kwi-blocker ye-TNF eyahlukeneyo okanye esinye isiyobisi se-biologist ngexesha elithile. Izizathu ezifanelekileyo zokutshintsha zingaquka:
- Impendulo enganelisekiyo kunyango
- Imiphumo engathandekiyo yonyango
- Ukuphumelela kwexesha elide
Sacela i-rheumatologist uScott J. Zashin, MD imibuzo embalwa malunga nokutshintsha i-TNF yakho.
- Ngaba kunokwenzeka ukuba isigulane sibe nempendulo engcono kwi-blocker ye-TNF eyahlukeneyo okanye ngaba kunjalo?
- Ingaba isigulana singabuya kwi-blocker ye-TNF emva kokuyimisa?
UDkt. Zashin waphendula wathi, "Ubuncinane iipesenti ezingama-70 zezigulane ezine-rheumatoid arthritis eziqala i-TNF blockers ziza kuphucula kakhulu imeko yazo. Izigulane ezininzi ziya kufumana i- methotrexate (iRheumatrex, iTrallall) okanye enye i- DMARD izidakamizwa ezichasene ne-rheumatic) zidibene ne-blocker ye-TNF.
Ukuba isigulane singaphenduli kwi-blocker yasekuqaleni ye-TNF emva kweenyanga ezintathu, ukutshintshela kwenye kuya kwandisa ithuba lokufumana inzuzo. Enyanisweni, nangona isigulane singaphenduli kwiiyobisi ezimbini ze-TNF, kusenokuba luncedo ukuzama okwesithathu. "
Njengokuba kunjalo, iziphumo zokufunda (ezipapashwe ngoJuni ngo-2010 kwiRheumatology) zagqiba ukuba izigulane ezine- spondyloarthritis ezahluleka ukuphendula kwi-Enbrel ye-Remicade njenge-agent yokuqala, zaphendule emva kokutshintsha, kungakhathaliseki ukuba ziguqule.
Olunye uphando oluthambileyo, olupapashwe kwi-Rheumatology ye-Clinical ne-Experimental ngo-2013, lwabonisa ukuba izigulane ezine-spondyloarthritis zaziyokwazi ukuhlala ixesha elide kunye ne-TNF blockers kunezigulane ze-rheumatoid arthritis, ngokuyinhloko ngenxa yecandelo legciwane le- spondylitis . Ngomdlavuza we-rheumatoid kunye ne-spondyloarthritis, izigulane zakwazi ukunamathela ne-Enbrel kunye neHuma ngokude zifaniswe ne-Remicade.
UDkt. Zashin wongezelela wathi, "Uninzi lwe-rheumatologists aluzange lusebenzise i-Kineret ngokuqhelekileyo ukunyanga i-rheumatoid arthritis ngenxa yokunciphisa ukusebenza kwayo kwaye kufuneka ijojoze imihla ngemihla." Kodwa ke, uKereeret uye wayiluncedo kakhulu kwezi gulane eziye zafumanisa uhlobo lwe-system of child's arthritis, kubizwa ngokuba sisifo . "
Ngokutsho kukaDkt. Zashin, ngelixa izigulane ezishiye unyango nge-Enbrel kunye neHuma zingabuyela kwisilwanyana ngaphandle kokukhathazeka, abo baye baxoshwa kwi-Remicade ixesha elide lijongene nomngcipheko wokuphendulwa kwegazi olungenokuba yingozi.
Imithombo:
Ukutshintshwa kwi-infliximab okanye i-etanercept kwi-adalimumab kwizigulane ezingavumiyo okanye ezingavumiyo nge-spondyloarthritis: isifundo seminyaka emine. Spadaro. A. et al. Rheumatology (Oxford). Juni 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20223813
Ukusinda kweziyobisi kwikhosi yokuqala ye-AgF anti-TNF kwizigulane ezine-rheumatoid arthritis kunye ne-seronegative spondyloarthritis: ukuhlalutya kwi-database ye-MonitorNet. Scire CA kunye al. I-Rheumatology yeeKliniki kunye noVavanyo. Novemba-Disemba 2013.
http://www.ncbi.nlm.nih.gov/pubmed/23981363
Impendulo, inxalenye, enikezwa nguScott J. Zashin, MD, uprofesa oncedisayo kliniki 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. UDkt. Zashin ngumlobi weArthritis ngaphandle kobuhlungu - Ummangaliso we-Anti-TNF Blockers kunye nombhali-mbhali we-Natural Arthritis Treatment.