Aimovig inonzi monoclonal antibody inodzivirira migraines
Kune marudzi maviri emigraine therapy: kubvisa kana kudzivirira. Kubvisa pamuviri kunoshandiswa panguva yekurwisana kwemigraine, nechinangwa chekumisa. Triptans uye NSAIDs zvakadai seAcetaminophen uye ibuprofen (Advil) inobvisa zvirwere.
Mishonga inodzivirira inoedza kuderedza kuwanda uye kuoma kwemusoro wemusoro. Iyi mishonga inonyatsorongerwa seyakanyorwa migraine-inodzivirira mishonga (OMPMs) uye inosanganisira vanodzvinyirira, anticonvulsants, uye beta-blockers.
Munyaya yaNovember 2017 yakabudiswa muNew England Journal of Medicine , Goadsby uye vanyori vanyori vakaongorora kukwanisa kweAimovig kune (erenumab) kudzivirira migraine kurwisa. Kusiyana neOIMM dzezvino, Aimovig chinhu chigadzirwa chebiologic-chinonzi antioclonal antibody. Kunyanya, Aimovig inodzivirira migraines nekudzivirira calcitonin peptidi yakabatana nepeptide (CGRP) receptor, iyo inobatanidza nemigraine activation.
Ndiani Aive Akabatanidzwa MuAimovig Miedzo?
Munguva yeChikamu 2 neChikamu chechitatu chemakiriniki, Aimovig yave ichiedzwa kune varwere vane mbiri uye vasingaperi migraines.
Episodic migraines inotsanangurwa sezvishoma kudarika 15 migraine kana mazuva ekushaya musoro pamwedzi, pamwe kana pasina kanara. Chronic migraines inorondedzerwa seinenge mazuva gumi nemashanu ari pamusoro pamwedzi. Mazuva masere gumi nemashanu awa mazuva gumi nemaviri ndeaya mazuva echirraine kana asina kanara.
Episodic migraines yakawanda-inenge 90 muzana yevanhu vane migraines vane ivo.
Pakati pe5% uye 8 muzana yevanhu vane migraine vane migraine isingaperi.
Nezvokuedzwa
Munyaya yaNovember 2017 yakabudiswa muNew England Journal ye Medicine , Goadsby uye vanyori vanyori vakaongorora kukwanisa kweAimovig kudzivirira migraine kurwisa.
Muchidzidzo ichi, pane 995 vatori vechikamu vakuru vakapatsanurwa kuva mapoka maviri ekuongorora uye boka rinodzora.
Boka rokutonga rakagamuchira injandi ye placebo, uye mapoka ekuedza akawana 70 mg kana 140 mg subcutaneous injection yaAimovig, inotarisirwa semitambo mitanhatu yakavharwa kwevhiki ina.
Maererano nevanyori, maitiro ose maviri "akaderedza migraine nguva zhinji, migumisiro yemigraines pamabasa ezuva nezuva, uye kushandiswa kwemishonga yakaoma migraine-chaiyo kwemwedzi mitanhatu."
Pamusoro pekutanga, nhamba yemazuva emigraine akawana mwedzi woga woga nevatori vechikamu mune chidzidzo chaive mazuva 8.3. Pakati pemwedzi mina nematanhatu ekurapa, nhamba yemazuva emigraine yakaderera ne 3.2 uye 3.7 mu 70-mg Aimovig uye 140-mg Aimovig mapoka, maererano.
Pakati pekutanga kwekudzidza uye mwedzi mina kusvika kumatanhatu ekurapa, mumapoka 70-mg, 43.3 muzana yevarwere vakawana zvishoma ne50 kubva muzana kuderedzwa kwemazuva emagraine anowanikwa mwedzi woga woga.
Pakati pekutanga kwekudzidza uye mwedzi mina kusvika kumitanhatu yekurapa, mumapoka 140-mg, 50 muzana yevarwere vakawana inenge 50 muzana kuderedzwa kwemazuva emigraine anowanikwa mwedzi woga woga.
Pakati pekutanga kwekudzidza uye mwedzi mina kusvika kumatanhatu ekurapa, kune avo vanogamuchira nzvimbo, 26.6 muzana vanoziva zvishoma ne50 kubva muzana kuderedzwa kwemazuva emigraine anowanikwa mwedzi woga woga.
Nhamba yemazuva apo varwere vaifanira kushandisa mishonga chaiyo yekurapa migraines yakaderera yakaderera ne 1.1 mazuva muboka-70-mg uye 1.6 mazuva muboka 140-mg kana ichienzaniswa ne 0.2 mazuva muboka re placebo.
Kukanganiswa kwezvinhu zvezuva nezuva kunoita kuti migraines irege kukanganisa. Kushandisa mubvunzo wemibvunzo, vatsvakurudzi vakaongorora kuvandudzwa kwekuita kwezvinoitwa zuva nezuva. Vakawana kuchinja kukuru kune avo vanogamuchira Aimovig.
Migumisiro yakaipisisa uye Kukwana
Kunyange zvazvo migumisiro yakaipa yeAimovig yakasarudzwa nehuwandu hwevatori vechikamu, zviitiko zvakashata izvi zvakanyanya kune zvakasiyana nevaya vanogamuchira nzvimbo.
Zvinonzwisisika, vanhu vakawanda vanogamuchira 70 mg yeAimovig vakatsanangura kurwadziwa panzvimbo yejojo kune avo vari muboka rekutonga.
Mienzaniso yezviitiko zvinowanzoitika zvakashata zvinosanganisira kupisa, kuputika kwepamusoro maitiro, uye sinusitis.
Chimwe chidimbu chekudzidza ndechekuti vatsvakurudzi havana kuisa varwere vasina ruzivo rwekurapa kubatsirwa kubva kumapoka maviri kana kupfuura emaOmM.
Zvisinei, vatsvakurudzi vakaisa varwere vakagumisa OMPM nekuda kwekushaya kukwana kwakakwana, kusava nemhinduro yakasimba, kana kusagadzikana kunokonzera matambudziko. Zvechokwadi, 38.7 kubva muzana yevarwere vari mumuenzaniso wacho vakanga vasati vamboona kubatsirwa kubva kuOmMM.
Uyezve, maererano neGoadsby uye vanyori vanyori:
Kubudirira kwakaratidzwa zvakafanana muchikamu chechipiri chemuedzo we erenumab inosanganisira varwere vane chisingagumi migraine, umo 68 muzana yevarwere vakanga vamborega migraine-mishonga yekudzivirira nekuda kwekushayikwa kwebasa kana kusagamuchirwa nemigumisiro.
Kana ichibatanidzwa nemigumisiro inobva kune dzimwe mitezo yechikamu chechipiri nechikamu chechitatu chekuongorora kushandiswa kweAimovig kune avo vane chronic and episodic migraine, zvinoita sekuti Aimovig inogona kubatsira kudzivirira episodic migraines.
Kutsvakurudza kwakawanda kunofanirwa kuitwa kujekesa kuchengetedzwa kwenguva refu kweAimovig, uyewo kuti yakareba sei migumisiro yacho inoguma.
Nzira yekuti Aimovig Inotanhira Kusvikira kuWIMM
Imwe misiyano huru pakati peAimovig uye OMPM ndeyokuti Aimovig inonyanya kurongedza zvakananga pathophysiological nzira dzinobatsira mukuita migraine.
Kwete kuongororwa kwakaitwa kuitira kuenzanisa migumisiro yeAimovig nedzimwe mishonga inoshandiswa kudzivirira migraine misoro. Uyezve, hakusi kuongororwa kwakawanda kuongorora kushanda kweMEMPs pachavo.
Maererano neAmerican Academy of Neurology:
Uchapupu hahunawanika pakuita kufananidzwa kwakasiyana-siyana pakati pevanhu vakawanda mukati mekirasi rimwe chete; uchapupu hwakadaro huchapa humwe hutano hwakakwana hwehukama hunobatsira uye kushivirira huwandu hwehuwandu hwehutano hwakawanda hwemishonga inorapa. Zvidzidzo zvinodiwa zvinonyatsoongororwa apo chirwere chekudzivirira chinotenderwa uye kuti mishonga inofanirwa kuve yakanyorwa sei.
Nhamba shomanana yezviongorori dzakaongorora kushanda kweMEMPs. Maererano neAAN, kune uchapupu hwakasimba kana huwandu hunotsigira hutano hwehutano hwekudzivirira hunotevera:
- Divalproex sodium, sodium valproate, uye topiramate (antiepileptic drugs)
- Metoprolol, propranolol, timolol, atenolol, uye nadolol (beta-blockers)
- Amitriptyline uye venlafaxine (antidepressants)
Uyezve, gabapentin, lamotrigine, clomipramine, uye fluoxetine, iyo inorayirwa kuti igadziriswe migraine, haifaniri kushanda pakudzivisa migraines.
Nyaya, kurapwa nemishonga inopesana nemaperembudzi kunoda kunyatsotevera kutevedza kwepachikwereti, kusapera kwechiropa, uye matatogenic effects zvakadai sekuberekwa kwekuzvarwa. Uyezve, divalproex sodium inogona kuwedzera kuwedzera. Kusvika ikozvino, zvinoita sekuti Aimovig haisi mhinduro dzakashata zvakadaro.
Chinhu chimwe chatinoziva pamusoro peMEMPs ndechekuti kunyatsoteerera kwakaderera. Mune mamwe mazwi, vanhu vakawanda vanotora mishonga iyi vanorega kuitora.
Muchidzidzo chekudzokorora chakabudiswa muCephalagia muna 2015, Hepp uye vashandi pamwe navo vakaongorora kubudirira kwemarudzi gumi nemaviri eOmMs ekurapwa kwekusingaperi kwemigraines. Pakati pevane 8688, kuratidzira maitiro pamwedzi mitanhatu kwakave pakati pe 26 muzana uye 29 muzana. Kwemwedzi gumi nemaviri, kuterera kwemitengo kwakaderera kusvika pakati pe17 muzana uye 20 muzana.
Maererano nevanyori:
Kunyange zvazvo zvikonzero zvekusava nehanya hazvina kutorwa munyaya dzekutsvaga, zvinyorwa zvakabudiswa kare zvinoratidza kuti kuderera kwakaderera kunogona kuonekwa kune zvimwe zvinhu, kusanganisira migumisiro uye / kana kusakwanisa kwehutano hweOmM. Uyezve, mazano ekurapwa neAAN anoratidzawo kuti mashomanana eOmMs anowanikwa chete ane hutano hwakanaka hwehutachiona hwehutano hwavo mukudzivisa migraine misoro.
Zvinofadza kuti vatsvakurudzi vakaona kuti ye14 OMPMs yakaedzwa, amitriptyline, nortriptyline, gabapentin, uye divalproex yakanga yakanyanyisa kuderera kwekutevedza kana ichienzaniswa ne-topiramate.
Neurostimulation
Heino nyaya yakakosha ine migraines: Hatinganyatsonzwisisi kuti vanoshanda sei. Pasina kunzwisisa zvakajeka nzira dzechirwere ichi, zvakaoma kuvaka zvinyorwa zvitsva uye kubvisa zvirwere zvinotarisa nzira dzakasiyana.
Funga ndima inotevera kubva munyaya yekuongorora ya2013 inonzi "Migraine: huro hwehuropi":
Mafungiro emagraine pathogenesis ave akaisa pfungwa pane imwe nzvimbo yekutanga yekutanga sekupararira kudengenyeka mu cortex kana kuti 'migraine generator' mu brain brain. Asi nguva yemazuva ekurwisana kwemagraine inoratidza kushanduka panguva imwechete muhutano hwehutano huzhinji hunoitika, uye hazvisi pachena kuti kune imwechete inotomical nzvimbo umo migraine inotanga kune varwere vose.
Kungofanana neAimovig, Cefaly inotarisira kukanganisa zvakananga pathogenesis ye migraine nekutsvaga nzira. Kusiyana neAimovig, iyo inopiwa sejojo, Cefaly inoratidzira ruzivo rwakagadzirirwa pamusoro pehuma. Iyo inokurudzira hutatu hwemhando, iyo inofungidzirwa kuti inotora basa guru mumigraines.
Cefaly akanga achangobvumirwa neDFA kwete kungofanirwa kupindira asiwo kurapa kwakanyanya, zvakare. Inouya mumaturo matatu: Cefaly Acute, Cefaly Prevent, uye Cefaly Dual. (Cefaly Dual ine mafungiro ezvinyorwa zvakaoma uye yekudzivirira kurapwa kwemagraines.)
Maererano nevanogadzirisa, Cefaly Prevent inotungamirira kushandiswa kwepasi kwakanyanya kunogona kushandiswa zuva rega rega kudzivirira migraine kurwisa.
Mumakiriniki ekuedzwa, kwakaitika pakati pe1999 na2012, avo vanogamuchira Cefaly kurapwa kwekudzivirira kwemigraine vakave nekuderera kukuru kwemaviri migraine uye mazuva ekuchema pashure pemwedzi mitatu yekushandiswa.
Kunyanya kunyanya, varwere vakagamuchira Cefaly kurapwa vakawana 29,7 muzana vashoma mazuva emurasi uye 32.3 muzana vashoma mazuva epamusoro. Uyezve, 38.2 muzana yevarwere vanogamuchira Cefaly vane ruzivo rwemashoma makumi mashanu ekuderedza mumwedzi wemwedzi migraine.
Mukuwedzera pakuva nemazuva mashoma emvura uye mawere, avo vanoshandisa Cefalywo vaida mishonga inorwisa anti-migraine ("mishonga yokununura"). Nhoroondo, pakanga pasina kuipa kwakakomba kune avo vanogamuchira Cefaly kurapwa.
Munguva yekutsvaga kwekutengeserana kwakaitwa naCefaly, 53 muzana yevarwere vakagamuchira chigadzirwa chacho vakafara nazvo. Vane 4 muzana yevashandisi vakashushikana kusagutsikana uye vakarondedzera zviduku zvinokanganisa, zvakadai sokurara, kuora musoro, kana kusungirirwa kunokonzerwa nechigadzirwa. Sezvo nekliniki miedzo, pakanga pasina mamiriro akaipisisa akaipa kune Cefaly kurapwa.
Shoko Rinobva
Kunyange zvazvo tisinganzwisisi zvakakwana kuti migraines inoshanda sei, zvitsva zvitsva zvakadai sebiologic chigadzirwa Aimovig, pamwe chete nechigadziro chekushaya pfungwa Cefaly, chinangwa chekuvhiringidza nzira dzechirwere ichi. Aimovig isati inofanira kugamuchirwa neCDA, asi Cefaly inowanikwa. Kana uchifarira mune izvi kana zvimwe zvirwere zvinodzivirira, kurukura navo neurologist yako.
> Sources:
> Charles, A. Migraine: huro hwehuropi. Ikozvino Maonero muNeurology. 2013; 26: 235-239.
> De Novo Kuenzanisa Chikumbiro cheCefaly Device . FDA.
> Goadsby PJ, et al. Dambudziko Rakataridzirwa reErenumab ye Episodic Migraine. The New England Journal of Medicine. 2017; 377: 2123-2132.
> Hepp Z, et al. Kubvuma kumuromo migraine-kudzivirira mishonga pakati pevarwere vane chirwere chisingaperi, Cephalagia. 2015; 35: 478-488.
> Rederer F, Penning S, Schoenen J. Transcutaneous Supraorbital Nerve Kusimudzira (t-SNS) neCefaly Device ye Migraine Prevention: A Review of Available Available. Pain uye Therapy. 2015; 4: 135-137.