FDA Inobvumidzwa Nezvinodhaka Zvinodhaka Zvinoderedza Kuderedzwa Gut Fat Yakagadzirwa ne15-18%
Kurongwa
Egrifta (tesamorelin) inoraswa, maitiro ekuwedzera-hormone-releasing hormone (GHRH) inogamuchirwa neU.S. Food and Drug Administration (FDA) munaNovember 2010 mukurapa kweHIV-inosangana lipodystrophy .
Nezve HIV-Yakabatana Lipodystrophy
Lipodystrophy inokonzerwa neHIV ndeyezviitiko zvinoratidzwa nehuwandu hwekuparadzanisa kwemafuta emuviri.
Mamiriro acho ezvinhu anowanzopa nekunyorera zvakakwana kwechiso, zvigunwe, kana zvidimbu, asi kazhinji zvichiita kuti mafuta aunganidze mukati mechidzamu, mazamu, kana kuti kumashure kwemutsipa (iyo yekupedzisira iyo inonzi "bufalo hump" -kufanana muchimiro).
Lipodystrophy inowanzobatanidzwa neHIV yakawanzobatanidzwa nemamwe marudzi emishonga inorwisa mabhakitiriya , kusanganisira protease inhibitors (PIs) uye dzimwe nucleoside reverse transcriptors (NRTIs) saZerit (stavudine) uye Videx (didanosine). Mamiriro acho angavewo ane hutachiwana hwehutachiona hweHIV, zvikurukuru hune hutachiona hwevasati vasati vatanga antiretroviral therapy.
Kunyange zvazvo lipodystrophy inowanikwa zvisinganyanyi kune vanhu vane HIV sezvo zvizvarwa zvitsva zvinorwisa antiretrovirals zvakatangwa, zvinoramba zviri dambudziko sezvo chirwere chacho hachiwanzochinjwa kana chikaitika uye kunyange kana mishonga inopomerwa ikamira.
Kurapa Kuratidzwa uye Migumisiro
Izvozvo zvinoratidzwa nevarwere vane utachiwana hweHIV kunyanya kuderedza mafuta akawanda (kureva, mafuta anowedzera mudumbu uye mukati memukatikati).
Izvo hazviiti sekuti hazvina maturo kune lipoatrophy (mafuta kurasikirwa) kwechiso, mhuka kana mitezo, kana kuunganidza mafuta pane mazamu kana mushure memutsipa.
Izvozvo zvinoshanda kuburikidza nekusimudzira chirwere chepituitary kuti isunungurire vanhu kukura hormone (HGH) , iyo iyo inozivikanwa kukurudzira lipolysis (kureva, kuparara kwe lipids uye triglycerides).
Dzidzo dzakaratidza kuti chirwere cheEgrifta chinogona kuderedza mafuta emimba kubva pakati pe15% ne17% zvichienzaniswa neT CT scan. Zvimwe mimwe miedzo muna 2014 zvakaratidza kuti Egrifta inogonawo kuderedza huwandu hwemafuta mukati mechiropa ne18%.
Dosage uye Administration
Iko kukurudzirwa kwevanhu vakuru veEgrift is 2mg injected subcutaneously (pasi peganda) kamwe chete zuva nezuva. Zvinokurudzirwa kuti Erifrifta injove muchero pasi pemutsva. Kushandura jekiseni nzvimbo dzinowanzobatsira kuderedza kuora uye / kana kuoma kweganda.
Izvozvo zvinoshandiswa zvakare kubva kune imwe chirwere chemishonga inoshandisa mvura yakasviba, iyo yekupedzisira iyo inowanikwa mune imwe yakasara ( inoratidzirwa ). Kana tadzorerwazve, mushonga wacho unofanira kushandiswa pakarepo. Izvo zvisina kugadziriswa Egrifta inofanira kuchengetwa mufiriji pakati pe 36 o F uye 46 o F (2 o C uye 8 o C).
Izvozvo zvinoratidzika hazviratidzirwi kuti uwedzere kurasikirwa.
Nguva Yakatarisa uye Kuongorora Kurapa
Sezvo nguva yakareba yezvinoitika kana kuti zvingave zvinobatsira zverapi hazvizivikanwe zvakazara, kushanda kwose kunofanira kuitwa kuti kuongorore mishonga yekurapa nenzira yeC CT scan kana kuenzanisa chiuno chekuyera zviyero. Murefu haafaniri kuratidza kuderedzwa kwakakwana nemaitiro aya, saka kufungidzirwa kunofanira kupiwa kumira kurapwa.
Nguva yekurapa inofanira kugara ichitarisana nekuratidzwa zvakananga nemumwe muongorori weHIV / AIDS ane ruzivo rwechirwere cheGHRH, kana nekubvunzurudza pakati pehutano hweHIV / AIDS uye anokwanisa kugumira kare.
Mazinga eaglucose anofanirwawo kuongorororwa nguva dzose panguva yekurapa sezvo Egrifta inogona kukonzera kusawirirana kweglucose kune vamwe, kuisa murwere mukana wekuwedzera wekukura kwechirwere cheshuga .
Maitiro Akasiyana-siyana (anowanikwa nevanenge 2% varwere)
- Joint pain (arthralgia)
- Pain in endings
- Uturu hwepamuviri (myalgia)
- Injecting site redness, kuzvimba kana kurwadziwa
- Kutinzwa kunzwa kweganda (paresthesia)
- Kusasarura kwepakati peganda (hypoesthesia)
- Mapundu
- Flushing
- Itching (pruritis)
- Nausea
- Kudzora
Kubatana Kwemishonga
Kuziva kunobatanidzwa nemishonga inotevera, kuderedza kushandiswa kwekudya / kuendeswa kwezvose zviri zviviri uye pamwe chete nemishonga inotevera:
- Cholesterol-kuderedza mishonga: Zocor (simvastatin)
- Utachiona hweHIV antiretroviral: Norvir (ritonavir)
Contraindications nekufungisisa
Izvozvo hazvifanirwi kupiwa kune munhu ane hutachiona hunoshingaira , kana achangobva kuongororwa kana kuti achidzokorora seHGH inogona kukonzera nhengo dzehutachiona (tumarara) kukura. Kunyatsofungisisa kunofanira kuitirwa kuvarwere vane zvironda zvisina kuipa kana avo vane nhoroondo yekubatwa kana kusagadzikana kwemaitiro, kuenzanisa zvingave zvingabatsirika nezvingangova nengozi.
Izvozvo zvinopesana nevarwere vane chirwere chekuita chirwere, chirwere chepituitary, hypopituitarism, musoro wemhepo, kana kubviswa kwechigamba chepituitary (hypophysectomy).
Izvozvi zvinopesanawo kune vakadzi vane pamuviri vane HIV sezvivara zvekuona zvinoreva kuwedzerwa panguva yekuzvitakura uye chero kuderedza nenzira yeGHRH kurapa kunogona kukuvadza fetus. Kana uchinge uchitakura, rega kugadzirisa kurapa.
Kuziva hakuratidziri kana murwere ane zivo inonzi hypersensitivity kune tesamorelin kana kuti diuretic Osmitrol (mannitol).
Kunyatsofungisisa kunofanirawo kuitwa kune avo vane chirwere cheshuga sezvinoitwa Egrifta zvinogona kuwedzera insulin kukura chikonzero 1 (IGF-1) mazinga. Nguva dzose kuongororwa kunofanira kuitwa kuitira kutarisa kukura kana kuwedzera kwekushaya chirwere cheshuga chetinopathy (kukurumidza kuitika kana kubata retina).
Sources:
US Food and Drug Administration (FDA). "FDA inobvumirana neArifrifta kuti iite Lipodystrophy mune varwere veHIV." Silver Spring, Maryland; gwaro rehurukuro rakabudiswa musi waNovember 10, 2010.
Stanley, T .; Feldpausch, M .; O, j ;; et al. "Migumisiro ye tesamorelin pamafuta ane hutachiwana muhutachiona hweHIV: imwe nzira inongorongedzwa, inokonzerwa ne-placebo-kutongwa." Nyaya yeAmerican Medical Association (JAMA). July 23-30, 2014; 312 (4): 380-389.