Kusiyana Kunokosha muEfficacy, Cost, uye Administration
TNF inhibitors (inozivikanwawo seN TNF blockers) ikirasi yemishonga inoderedza kupisa nekudzivirira mafungiro emusununguko. Zvinoshandiswa kurapa zvinetso zvakasiyana-siyana zve autoimmune kusanganisira rheumatoid arthritis (RA) , psoriasis, psoriatic arthritis, ulcerative colitis, uye chirwere cha Crohn.
Iyo mitatu yezvinozivikanwa zvikuru TNF inhibitors inoshandiswa kurapa RA ndeyi:
Kunyange zvazvo mishonga yose mitatu ichidzivisa mitezo yomuviri kune tumor necrosis factor (TNF) -huwandu hweprotini, hunonzi cytokine . iyo inokonzera kutuka-imwe neimwe ine yakasiyana yemakemikari yakarongeka pamwe nezvimwe zvikomborero zvakakwana uye zvisingakwanisi.
Iyo TNF Inhibitors Inoshanda Sei?
TNF inhibitors ndeye rudzi rwechirevo chemishonga inoshandiswa kurapa zvirwere zvekudzivirira muviri seRA. Apo pavanonyatsotaridzira TNF, mamwe mabhiologics anotora ma cytokines akadai se interleukin kana kuchinja nzira iyo masero ezvirwere (anonzi T-cells kana B-cells) anoshanda.
TNF inhibitors yava kunyanya kukosha mashandisirwo muhutungamiri uye kurapwa kweRA kubvira pakuvambwa kwavo muna 1998. Izvo zvinobudirira muvanopfuura makumi manomwe kubva muzana yevanhu vanorarama nechirwere, kusanganisira avo vasina kupindura mutsara wekutanga methotrexate therapy.
Kana yakashandiswa pamwe chete ne methotrexate, TNF inhibitors inozivikanwa kuva yakanyatsobudirira pakudzokorora hupenyu hweVAR vanorwara, kazhinji munguva pfupi semavhiki gumi nemaviri.
Kusiyana kweUtungamiri
Nepo nzira yekuita nayo yakawanda kana isina yakafanana kune mishonga yose mitatu, Enbrel, Humira, uye Remicade vane nhamba dzakasiyana-siyana. Mukuru pakati pavo ndeyekutungamirirwa kwezvinodhaka uye kuwedzerwa kwezvering.
Kunyange zvazvo pane zvinogona kuchinja mukushandisa kwezvinodhaka, zvinowanzotarisirwa sezvinotevera:
- Enbrel inopihwa nejasi rinopinza (mukati meganda) kamwe kana kaviri pavhiki.
- Humira inopihwa nejasi rinopinza rimwe nerimwe vhiki.
- Remicade inoda kuvhiringidzika kwemukati kwemavhiki mana kusvika masere.
Uyezve, kusiyana neRicicade, Enbrel naHuma vanogona kuzviriritira nemutero-unotungamirirwa. peni isina kuvharwa (yakadai seyo inoshandiswa nevechirwere cheshuga kuti injove insulin).
Kusiyana kweEfficacy
Imwe nzira iyo mishonga inopesana nayo ndeyehuwandu hwehutano hwehutano, hunoreva nguva yakawanda yaunogona kuishandisa usati wafanira kuchinja kurapwa.
Kusvika pakupedzisira, chidzidzo chekudzidza muna 2013 nemasayendisiti paYunivhesiti yeValladolid kuSpain yakaongorora mavhareji ekurehwa kweEbrel, Humira, uye Remicade muna 91 vanhu vane RA.
Zvavakawana ndezvokuti zvose Enbrel uye Humira zvakave nenguva yekushanda kwemakore manomwe (mazuva 2,561 nemazuva 2 769, zvichienderana). Nokuenzanisa, Remicade aive nemuviri wehuwandu hwehutano hwemakore anopfuura mashanu (mazuva 1,853).
Pakati pemishonga mitatu, Enbrel akaratidza nguva yakakura yekushanda, kunyanya pakati pevakadzi vakaramba vachirapa kwemavhareji emakore anenge mapfumbamwe (mazuva 3191). Uyezve, vanhu vakwegura paEnbrel vakanga vasingagoni kuchinja kune imwe TNF biologic.
Kunyange zvazvo mhedzisiro yacho isingakwaniswi nezviyero zvekudzidza, vatsvakurudzi vakagumisa kuti, yevatatu veTEN inhibitors, Enbrel vakaratidza zvakajeka kukunda.
Kusiyanisa muDzimba
TNF inhibitors yose inodhura zvikuru kana ichienzaniswa nedzimwe madhiragi eR, nyaya iyo inobatsira pakurapa kwako.
Kunyange zvazvo kukwanisa kwemishonga iyi kunogona kuvandudzwa mushure mekutengesa muinishuwarensi yekubhadhara, kubhadhara zvekutengesa, uye zvirongwa zvekubatsira varwere, unogona kutarisira mutengo wose wekuderera zvakanyanya mukati memazera aya:
- Humira inodhura pakati pe $ 1,800 uye $ 2 400 pamwedzi.
- Enbrel inodarika zvinopfuura $ 4,000 pamwedzi.
- Chirwere chimwe chete chaRicicade chinogona kutengesa kubva kune $ 1,250 kusvika ku $ 2,500, zvichienderana nokuti iwe unoda kupfura mavhiki mana kana masvondo masere.
NeRicicade, zvakare kukosha kufungidzira kudhura kwepachipatara mari. Kusiyana neizvi, Enbrel naHumira havazoiti mari idzi kana mukasarudza kuzvidya.
Pakupedzisira, mari yechokwadi yekurapa ichave yakatarisana neinishuwarenzi yako yekugadzirisa uye iwe unofanirwa kubhadhara kubhadhara kubhadharo sekubhadhara sekupiwa kwevakiki veEnbrel, Humira, uye Remicade.
> Kwakabva:
> Martinez-Santana, V ,; Gonzalez-Sarmiento, E ;; Calleja-Hernandez, M. et al. "Kufananidza kwekuchengetedzwa kwemishonga kwechirwere chetachiona necrosis chinopesana nevatadzi mu rheumatoid arthritis." Murwere Anosarudza Kutendeseka . 2013; 7: 719-27. DOI: 10.2147 / PPA.S47453.