Inofungidzirwa mamiriyoni makumi maviri nemaviri eAmerica anorarama nemagetsi anonyanyisa kana "akaremara": chisingaiti uye chinogona kunyadzisa mamiriro ezvinhu akaoma kubata. Kwemakore anopfuura makumi matatu, pakange kusina mishonga mitsva yekurapa chirwere ichi. Zvisinei, muna 2012, FDA yakabvumira Myrbetriq (mirabegron) kuti iite chirwere chisina kumira.
Chirwere chekushanda zvakanyanya kana kukurudzira incontinence kunoreva kusagadzikana kwemuviri wemusefu.
Mushonga wekuchera chikamu chikamu cheshumba, uye kana zvisinganyanyi kushanda, zvinopindirana zvikwereti, uye kuputika kwemuguta kunoitika.
Chirwere chekushanda chakanyanya ndiyo inowanzovhiringidza urinary incontinence. Vakadzi vane chirwere ichi vanonzwa sechishuwo chakanyanya chokuramba ichikuteverwa nekutevedza kusingadzorwiki. Varume vanowana zviratidzo zvakafanana, asi kuora kunogona kukanganisa ne benign prostatic hypertrophy kana kudzivirira kwechiremba.
Previous Treatment Options
Pamberi pekubudiswa kweMyrbetriq, chikwata chinoputika chakashandiswa uchishandisa pelvic pasi (Kegel) maitiro uye biofeedback; mararamiro ekuchinja, akadai sekureruka kana caffeine kudzivisa; onabotulinumtoxinA kana Botox injection mukati memusor muscle; uye antimuscarinic zvinodhaka zvakadai seDetrol (tolterodine), Urotrol (oxybutynin), uye solifenacin.
Antimuscarinic mishonga ine misi yakaipa yakaipa iyo inoita kuti irege kuvhiringidzwa kune vanhu vakawanda vanoitora. Iyi migumisiro yakaipa inosanganisira muromo wakaoma, kuvhiringidzika, maonero asina kunaka uye kukanganiswa kwepfungwa.
(Iyi inxidrome inowanzobatanidzwa neshoko rokuti, "Mapofu semakumbo, anopenga seanopenga, akachena sebhetheni, anopisa seHadhesi, yakaoma sefupa, chifukidzo uye chikwata chinorasikirwa nezwi, uye mwoyo unomhanya uri woga." )
Kubatsirwa kweMyrbetriq
Myrbetriq inonyanya kujekesa pane zviito zvayo kupfuura antimuscarinic zvinodhaka zvinowanzoshandiswa kurapa chisingaiti chechirwere.
Myrbetriq hainawo kurwisana netsitsi inotyisa yenheyo zvakapararira sezvinoita antimuscarinic zvinodhaka. Kunyanya, mirabegron inonzi beta - 3 adrenergic agonist iyo inonyanya kukanganisa ma-receptor mumusungo wekucheka (97 muzana yeBaa -3 mRNA inogadzirwa nemuviri inobudiswa mumusana wekudzivirira).
Kusiyana nemagetsi antimuscarinic, mirabegron haina kupindira ne beta-1 uye beta-2 receptors mune dzimwe nhengo dzomuviri. Mune mamwe mazwi, apo antimuscarinic madhiragi ane chinangwa chisina kunaka uye inoshandisa zvirongwa zvakasiyana-siyana zvemuviri, mirabegron inonyatsojeka uye inonyanya kuchinja chikafu.
Clinical Trial Results and Effects Side
Munguva yeChikamu II neChikamu III mishonga yemakiriniki, Myrbetriq yakaedzwa mumasangano anopfuura 10 500. Mune zvidzidzo izvi, vatori vechikamu vakaratidza kuderera kwehuwandu hwemvura yakasvibiswa, nhamba yezviitiko zvekukurumidzira, nhamba ye incontinence episodes uye nhamba yezvinyorwa zvekunyora (usikutime incontinence)
Kunyange zvazvo Myrbetriq yakaratidza zvakanyanya kuvhiringidzika kudarika antimuscarinic zvinodhaka, munguva yemakiriniki, vamwe vanhu vachiri nemigumisiro yakaipa inosanganisira:
- kuwedzerwa ropa
- urinary tract infection
- marwadzo emudumbu
- yakakosha mwoyo
- yakakosha ropa
- kutonhora-kufanana nezviratidzo
Kunyange zvazvo kuwedzerwa mumoyo wehuwandu uye kuwedzerwa kweropa kudarika kushandiswa kweMyrbetriq vane mwero, dzimwe nyanzvi dzinonetseka pamusoro pemigumisiro yemoya yeMybetbetriq.
Kunyanya kufambidzana, pane zvishoma zvitsvakurudzo zvekushandisa kwaMybetriq kuvanhu vakuru vakwegura kune makore makumi manomwe; saka, vamwe vanachiremba havasi kupa mishonga iyi kune varwere vakwegura vane zvinetso zvemwoyo uye zvepvo. Uyezve, hazvisati zvinyatsojeka kana Myrbetriq inoshanda kana yakashandiswa ne antimuscarinic zvinodhaka.
MunaAugust 2015, FDA yakabudisa hutungamiri huchibva pamushure pekugadzirisa zviitiko neMyrbetriq. Mushure mekunge mishonga ichibudiswa kuvanhu, vamwe vanhu vakaona zvinotevera:
- nausea
- angioedema (kuzvimba) kwechiso, rurimi kana ruzha
- utchiness (pruritis)
Nyaya dze angioedema yechipiri kusvika kushandiswa kweMyrbetriq inogona kuisa upenyu pangozi kana iyo yepamusoro yemhepo ichivharwa.
Kana iwe uine angioedema kana chimwe chipi zvacho pamusoro pezviratidzo mushure mokutora mishonga iyi, pakarepo danai nhepfenyuro yekukurumidzira kana kutsvaga chiremba anogona kubatsira.
Mukuwedzera pakuva nemwoyo murefu kune antimuscarinic zvinodhaka mumakiriniki ekuedza, Myrbetriq yakaratidzawo kuvandudza hutano hwehupenyu huri pakati pevanhu vane chikwata chinopfurikidza. Pasi pose, Myrbetriq inoratidzika seyo nzira itsva inopikira yekurapa chisimba chisingaitiki zvikuru pakati pevanhu vasingakwanisi kushivirira antimuscarinic zvinodhaka. Kunyange zvakadaro, tsvakurudzo dzakawanda dzinofanira kuitika tisati tanyatsonyatsonzwisisa mavara ayo ekurapwa neMyrbetriq.
Sources:
Chapple, CR. Mirabegron muChirwere Chisinganyanyi Kuita: Kuongorora kweEfficacy, Safety, uye Kushushikana. Neurourology uye Urodynamics. 2013.
Harper G, Johnston C, Landefeld C. Geriatric Disorders. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Ikozvino Kurapa Kurapa Nekurapa 2015 . New York, NY: McGraw-Hill; 2014.
Khullar V et al. Mitsara-Mhinduro Dzakabvunzwa Ne b3-Adrenoceptor Agonist Mirabegron muChirongwa cheChitatu III muvarwere Neine Chirwere Chisingakoshi. Neurourology uye Urodynamics. 2015.
> Myrbetriq (mirabegron) Yakagadzirirwa-release Tablets. www.fda.gov.