Novel Mishonga Inogona Kubata Zvose 6 Matambudziko mumavhiki masere
Mavyret (glecapravir, pibrentasvir) chirwere chinogadziriswa chinoshandiswa nemishonga inoshandiswa mukurapwa kwehutachiona hweHIVV (HCV) husingaperi. Mishonga inoshandiswa mubasa reMavyret nekuvhara mapuroteni maviri ega kuti hutachiwana hunoda kudzokorora.
Mavyret akatenderwa musi waAugust 3, 2017 neU.S. Food and Drug Administration kuti ishandiswe kune vanhu vakuru 18 uye kupfuura. Kutsvakurudza kunoratidza kuti mishonga inogona kuwana zvirwere zvepakati pe 92 muzana ne100 muzana zvichienderana neHCV subtype, chimiro chinowedzera kana zvishoma maererano nemamwe maitiro anonyatsotarisa (DAAs) ikozvino anoshandiswa muhutachiona hweH hepatitis C.
Pros uye Cons
Mavyret anokwanisa kurapa matambudziko matanhatu eHCV ( genotypes ) uye anogona kushandiswa vose muvanhu vasina kumbobudiswa pachena nemishonga yeHCV nevaya vakambokundikana kurapwa. Uyezve, mishonga inogona kushandiswa kune vanhu vane chikwereti chepirhosis (umo chiropa ichiri kushanda).
Mavyret ane chimwe chinhu chinonyanya kukosha pamusoro pemishonga yakadaro mukuti inogona kubata chirwere chisingaperi chehepatitis C mumasvondo masere masere. Mamwe mimwe mishonga inoda zvisati zviduku masvondo gumi nemaviri kune vatsva vanorapwa. Izvi zvinosanganisira kusanganiswa kweHCV drug Epclusa iyo inobvumidzwawo kune dzose sechitanhatu genotypes.
Zvisinei, kusiyana neEpclusa, Mavyret haikwanise kushandiswa kune vanhu vane chirwere chinonzi decompensed cirrhosis (avo vane zviputi havasisiri kushanda).
Chimwe chikamu chikuru chinoita mutengo . Kunyange zvazvo zvinodhaka zvakafanana neEpclusa zvinotakura mutengo wakawanda wepakati pe $ 75,000 kwemaawa gumi nemaviri (kana $ 890 pamapiritsi), Mavyret anopiwa pa $ 26,400 kwemavhiki masere masere (kana kuti $ 439 pamatafura).
Misiyano yemutengo inogona kuva yakakwana kugutsa vatsigiri vehutano kuti vawedzere kurapwa kune mamiriyoni 3.9 eMamerica anorwara neHCV, vazhinji vavo vanofanira kumirira kusvika kune chiremera chakakomba chechiropa musati mishonga isingagamuchirwa.
Kunyora Zvikurudzira
Nhamba yakakurudzirwa yeMavyret ndehwendefa mitatu inotorwa kamwe chete zuva nezuva nechingwa.
Pirafura imwe neimwe ine makirogiramu zana e glecaprevir uye 40 milligrams yepibrentasvir. Mahwendefa acho akavhara, akave akareba, akafukidzwa nefirimu, uye akafukidzwa ne "NXT" kune rumwe rutivi.
Nguva yerapi inokonzerwa neHCV genotype, ruzivo rwehutano, uye chiropa chemuviri wemurwere, sezvinotevera:
- Pakutanga kusatenderwa pasina cirrhosis: vhiki masere
- Pakutanga isingabatanidzwi ne-cirrhosis inobhadharwa: mavhiki 12
- Yakaremberedzwa neHCV genotype 1, 2, 4, 5, uye 6 isina chepirhosis: masere kusvika masere makumi matanhatu zvichienderana nerapfuura
- Yakazobatwa neHCV genotypes 1, 2, 4, 5, uye 6 nemari yakapiwa cheprhosis: masvondo 12 kusvika ku16 zvichienderana nehutano hwekare
- Yakaremberedzwa neHCV genotype 3 kana kuti pasina cirrhosis: masvondo gumi nematanhatu
Vanenge 75 kubva muzana veAmerica vane hepatitis C vane geneotype 1, iyo ndiyo yakawanda zvikuru asiwo yakaoma zvikuru kubata. Kusiyanisa, pakati pe20 ne25 muzana vane genotype 2 uye 3, nepo zvishoma zvishoma zvishoma zvine genotypes 4, 5, kana 6.
Migumisiro Yechiri
Dzachizvarwa chekare DAAs saMavyret vane zvishoma zvisingabatsiri kupfuura zvidzidzo zvechizvarwa chekare, zvizhinji zvacho zvaisanganisira drug pegylated interferon ( peginterferon ) uye ribavirin . Zvipembenene zvakanyanya zvinowanzobatanidzwa naMavyret (zvinowanikwa mune vanopfuura mashanu muzana yevarwere) zvinosanganisira:
- Headache
- Kuneta
- Nausea
- Diarrhea
Kazhinji kutaura, migumisiro yemigumisiro inogadziriswa uye inowanzovandudza munguva. Kutaura zvazviri, kutsvakurudza kusati kwatengeserana kwakagumisa kuti pasi pezana kubva muzana yevanhu vari paMavyret vakagadzirirwa kurapwa semhaka yekusagadzikana migumisiro.
Kubatana Kwemishonga
Kushandiswa kwerafampin-based medication, inowanzoshandiswa kurapa tuberculosis, inopesana kuti ishandiswe naMavyret uye inofanira kuregwa musati yatanga kurapwa. Izvi zvinosanganisira zvinodhaka nemazita ezita rinonzi Mycobutin, Rifater, Rifamate, Rimactane, Rifadin, uye Priftin.
Mamwe madhiragi anozivikanwa kuti ataurirane naMavyret uye anogona kuwedzera kana kuderedza kukohwa kweMavyret muropa.
Izvi zvinotevera hazvikurudzirwi kuti zvishandiswe naMawvyret:
- Carbamepazine, aisashandisa kurapa uye bipolar disorder
- Ethinyl estradiol (estrogen) -ine mishonga yekuberekwa kwemishonga
- Sustiva (efavirenz) anoshandiswa muhutano hweHIV
- Atorvastatin, lovastatin, uye simvastatin inoshandiswa kurapa high cholesterol
- St. John's Wort
Chiropa Impairment
Mavyret inopesana kuti inoshandiswa kune vanhu vane chirwere chakakomba chechiropa (sezvinoyerwa neChikwata cheChidiki-Pugh C) uye hachina kukurudzirwa kune chero munhu ane kunyange kuora mwoyo kwakakwana (Child-Pugh B).
Chiropa basa kuongororwa kunoratidzirwa kusati kwava kutanga kwerapi kuti urege kunetseka. Nhamba yeChipiri-Pugh inobatsirawo pakusarudza kuoma kwechiropa chechiropa zvinoenderana neropa rekuongorora uye kuongorora kwezviratidzo zvinoratidza.
Hepatitis B Reactivation
Mavyret inofanira kushandiswa nekuchenjerera kune vanhu vane hepatitis B uye hepatitis C. Hutachiona hweH hepatitis B (HBV) yave ichizivikanwa kuti inoshanda panguva iyo kana nguva pfupi mushure mekurapa. Kubudirira kunogona kuendeswa nezviratidzo zve jaundice uye nekuputika kwechiropa. Kana kurapwa kusina kusimbiswa pakarepo, kudzokerazve kunogona kutungamirira kuchiropa kusakundikana uye kunyange rufu.
Kunyange zvazvo hutachiona hweHBV husinganzwisisi kushandiswa kweMavyret, zvinoda kutarisa zvakanyanya zvevhenekeri dzechiropa kuti zviratidze zviratidzo zvekutanga zvekuitazve.
Mukubata
Kunyange zvazvo Mavyret isingabvumirwi nekamuviri pamuviri, pane chidiki chekliniki yevanhu inowanikwa kuti iongorore ngozi chaiyo. Nezvo zvichitaurirwa, zvidzidzo zvemhuka zvakaratidza kuti kushandiswa kweglecaprevir uye pibrentasvir panguva yekuzvitakura hazvibatanidzi nehutachiona husina kunaka, kusanganisira kuvepo panguva yekuyamwisa.
Kubvunzurudza kunyanzvi kunokurudzirwa kwete kungoona zvikomborero uye ngozi dzekurapa asi kubatsira kubatsira kana kurapwa iyo nyaya yekukurumidzira kana chimwe chinhu chinogona kunonoka kusvikira mushure mokutora.
Kudzivirira kubata pamuviri panguva yekurapa, vakaroorana vanorayirwa kushandisa maitiro maviri asingaiti mahomoni ekudzivirira kubata pamuviri panguva uye kusvika kumwedzi mitanhatu mushure mokupera kwerapi. Sezvo isrogen-based birth control isingakurudzirwi, taura nachiremba wako kuti uone kana chirongwa cheprogestin-chete chepabonde chinogona kunge chakafanira.
> Sources:
> Abbie, Inc. "Pfungwa Dzokunyora Mashoko: Mavyret (glecaprevir uye pibrentasvir) mahwendefa, kumushandira mumuromo Pakutanga US Approval: 2017." Chicago, Illinois; yakarongedzwa muna December 2017.
> Foster, G .; Gane, E .; Asatryan, A. et al. "KUGUMIRIRA-3: kuchengetedza uye kushanda kweglecaprevir / pibrentasvir kana zvichienzaniswa ne sofosbuvir pamwe daclatasvir muhutano-naïve HCV genotype varwere vane 3 vasina chirwere chendrhosis." J Hepatol. 2017; 66 (Suppl 1): S33.
> US Food and Drug Administration. "FDA inobvumira Mavyret neHepatitis C." Silver Spring, Maryland; yakabudiswa musi waAugust 3, 2017.