Inotarisa Sezvo - Asi Mibvunzo Rambai
Imwe nyaya inowanika muNew England Journal yemishonga ekupera kwaAugust, 2014 yakasimudza mukana wekugadzirisa kutsva mukurapa kwekushaya mwoyo . Nyaya yacho inotsanangura zvinowanikwa kubva kuPARADIGM-HF yekudzidza, umo varwere vane kukanganisa kwemwoyo vakabatwa nemano inoongorora mishonga. Mushonga uyu, wakagadzirwa naNovartis, wakatsva zvokuti hauna kutombotumidzwa zita-panguva iyo inonzi "LCZ696".
LCZ696 chaizvo inoumbwa nemishonga miviri yakabatanidzwa pamwechete - valsartan (iyo inoshandiswa zvikuru ARB inhibitor) uye mutevedzeri mutsva, sacubitril. Sacubitril inoshandisa nekudzivisa enzyme neprilysin , uye nemhaka yehutachivi hwehutachiona hwemapeptide anowedzera. Nemhaka yekuti natriuretic peptides inogona kubatsira mukushaya simba kwemoyo, vatsvakurudzi vakataura kuti LCZ696 inogona kuvandudza mugumisiro wevarwere vane chirwere ichi. Migumisiro yePARADIGM-HF yekuongorora inoratidza kuti vatsvakurudzi vakanga vakarurama.
Muchidzidzo ichi, vanopfuura 8000 varwere vane mwoyo yekukundikana vakashandurwa kuti vawane kana LCZ696, kana kuti chirwere chinowanzoshandisa ACE inhibitor enalapril. Mune varwere vakatora LCZ696, mushure memavhareji emwedzi 27 mukana wekurapwa kwepfungwa yekushaya simba kwemoyo uye pangozi yekufa zvose zvakaderedzwa ne-20%. Iyi nhanho yekuvandudza, pamusoro pezvino inonzi inofanirwa kurapwa kwepfungwa kusakona, zvechokwadi inoshamisa.
Sei Chidzidzo Ichi Chikosha?
Migumisiro yePARADIGM-HF inokosha kune zvikonzero zviviri. Chokutanga, zvinoratidza kuti mishonga iyi LCZ696 inofanira kupa tariro itsva kune varwere vazhinji vane mwoyo unoparara - kana yakabvumidzwa kushandiswa neDFA.
Uye yechipiri, chidzidzo ichi chinozarura nzira itsva yekutora mwoyo kusakundikana.
Saizvozvowo, tinogona kutarisira mimwe mishonga inokurudzirwa iyo, saLCZ696, inodzivisa enzyme neprilysin.
Rini LCZ696 Richawanikwa?
Iyo mishonga mitsva haigoni kurongerwa kusvikira ichipfuura kuongororwa kwakaoma neDFA. Tichifunga kuti zvose zvinopfuurira zvakanaka nekuongororwa uku, wekutanga tinogona kutarisira kuti chirwere ichi chibvumirwe kushandiswa chingadai chiri nguva muna 2015.
Pane Mikana Dzakanganisa NaLCZ696?
Panguva ino, chirongwa chePARADIGM-HF chiri kupemberera sechinhu chitsva mukurapa kwekushaya mwoyo. Uye isu tose tine tarisiro yokuti inoshanduka kuva iyo. Zvisinei, kune zvikonzero zvitanhatu zvekuti tive nechishuvo chedu kwenguva.
Chokutanga, "kutsvaga mutsva" kunoziviswa nguva dzose mushure mekuongorora zvipatara nemishonga mitsva. Uye dzimwe nguva zvinotarisa kuti kubudirira kwechokwadi kwakaitika zvechokwadi, kakawanda zvinowanzoitika kuti mushonga mutsva unogona kupa zvakawanda ruzivo rwemukati, uye unogona kunge usisina kubudirira, kupfuura pakutanga wakaonekwa.
Chechipiri, pamusoro pemakore gumi apfuura mumwe mushonga unonzi nesiritide (Natrecor) wakaitwawo sekunakidza mukurapa kwekushaya mwoyo. Izvi zvakakosha nokuti nesiritide haina kungoerekana ichinyanya kuwedzera mazinga evanhu vepatridetic peptides sezvinoita LCZ696; nesiritide yaiva natriuretic peptide.
Zvakatora makore anoverengeka, uye mamwe majekiseni emakiriniki, kuratidza kuti nesiritide chaizvoizvo yakanga ine ruzivo rwemukati (kana iripo) mukurapa mwoyo kusakundikana. Iyi nhoroondo ingangodaro inofanira kupisa zvishoma zvekushingaira ikozvino kunoratidzwa kwaLCZ696.
Uye Chechitatu. . .
Neprilysin ine mabasa anoverengeka mukuwedzera pakuderedza mazinga evanhu ve natriuretic peptides, uye mamwe emabasa aya anobatsira. Kunyanya, neprilysin inogona kubatsira kudzivirira dzimwe zvirwere zvakabatana nekuunganidza kwemaprotein asingadi mumuviri, akadai seAlzheimer's disease uye amyloidosis , uye kunyange kenza yeprotate . Saka kuvhara neprilysin hakusi chinhu chakanaka chose chekuita.
Iwe unogona kuverenga zvakawanda pamusoro pezvinetso izvi zvinogona kuitika apa.
- Heino nheyo yeLCZ696 (yava kunzi Entresto), yakagamuchirwa neDFA munaJuly, 2015.
Sources:
McMurray JJV, Packer M, Desai AS, uye al. Angiotensin-neprilysin inhibition uye inalapril mumoyo kusakundikana. N Engl J Med 2014; DOI: 10.156 / NEJMoa1409077.
Jessup M. Neprilysin inhibition-chirongwa chemazwi chekushaya mwoyo. N Engl J Med 2014; DOI: 10.1056 / NEJMe1409898.
Nalivaeva NN, Belyaev ND, IA Zhuravin, IA, et al. The Peptidase yaAlzheimer's Amyloid-Degrading, Neprilysin: Tinogona Kuitonga Here? International Journal of Alzheimer's Disease Volume 2012 (2012), Article ID 383796. Inowanikwa pa: http://dx.doi.org/10.1155/2012/383796 (yakasvika 9/2/2014).