Biologic zvinodhaka , izvo zvakashambadzirwa kune mamwe marudzi ezvokuvhiringidza arthritis kubvira muna 1998, zvinoshandiswa kana kuiswa mukati kana kuzviuraya . Zvimwe zvinokonzera, izvo zvinogona kuitika nemishonga iyi, inonzi inonzi infusion reactions kana injection site reactions. Inotyisa inotyisa, handizvo here? Asi, iwe unofanirwa kuziva kuti maitiro acho haawanzowi uye anowanzopfuura asingabatsiri.
Kazhinji Kuvhiringidzwa Kwakaitwa Nemiitiro
Matambudziko anowanzoenderana nekukanganiswa kwemawere anogona kusanganisira misoro, kusuruvara, urticaria (mikoko), pruritus (itching), kupisa, kuputika, fivha, chills, tachycardia (kukurumidza kutsamwa kwomwoyo), uye dyspnea (kunetseka kufema).
Kunyange zvazvo zvisingawanzoitiki, kushanda kwakasimba kana kuitika kwevanaphylactic kunogona kuitika. Mumamiriro ezvinhu akadaro, kuoma kwebhokisi, bronchospasm, hypotension (kuderera kweropa redu), diaphoresis (kutuka), kana anaphylaxis (chirwere chakanyanya kuitika kune imwe puroteni yakabva kune dzimwe nyika inoguma kubva kune yakambosangana nayo) inogona kuitika. Kana chirwere chakaipa chikawedzera, kurapa kwechilogiki kunofanira kumira pakarepo uye kutarisirwa kwekukurumidzira kwakapiwa. Mune zvimwe zviitiko, utano husati wapera uye acetaminophen, an antihistamine, uye kristi-acting corticosteroid inogona kubatsira kudzivirira kupindira kwemasanganiswa.
Maererano nevanyori veRheumatoid Arthritis: Kutanga Kuongorora uye Kurapa , dambudziko rekuongorora kwechipatara rakaratidza kuti nepo vanenge 20 muzana yevarwere vakabata Remicade (infliximab) vaine maitiro ekuderedza, vasati vasvika 1% vevarwere vakagadzirirwa remicade vakawana kupindira kwakanyanya kwemafuro uye asi 2,5% chete yekupindira kwevhirwere pakati pevarwere vakagadzirirwa remicade vakatungamirirwa kuregererwa kwechirwere.
Kazhinji, kugadziriswa kwekodzero kunobatanidza naRicicade kunoitika panguva yekudzivirira kana mukati maawa maviri mushure mokunge kupera kwapera.
Ngationei kuti kujekesa chii kune mamwe madhigiriki zvinoratidzirwa, tichichengeta mupfungwa kuti kuedza kwakasiyana-siyana kwekliniki hakugoni kuenzaniswa (semuenzaniso, Remicade mhinduro dzisingagoni kuenzaniswa neCononi test results) uye nhepfenyuro yekuedza dhesi haikwanisi kufanana nehuwandu hwemazuva echokwadi tsika.
- Simponi Aria: Muchikamu chinodzora chekuedzwa 1 (kuburikidza nevhiki 24), 1.1% yeC Simponi Aria infusions yaibatanidza nehuwandu hwekuvhiringidza huenzaniswa ne2.2% yevhiringidzi muboka rekutonga. Rash ndiyo yakanyanya kufarira kugadzirisa. Hapana kupindira kwakakanganiswa kwemaitiro kwakataurwa.
- Orencia (abatacept): Orencia zvidzidzo III, IV, uye V zvinoratidza kuti kugadzirisa kwemaitiro kwakanyanya kwaive pakati pevarwere veOrencia vakabata-kuenzaniswa ne placebo (9% vs. 6% zvichienderana). Zviitiko zvinowanzotaurwa zvakange zviri mutsivi, musoro, uye hypotension (1-2%). Vashoma kupfuura 1% yevarwere veOrencia vakarapwa vakasiya kushandiswa kwechirwere ichi nekuda kwekukanganisa kwakanyanya kupindirana. Anaphylaxis yakaitika muzasi pe1% yevarwere vakabata naOrencia.
- Actemra (tocilizumb): Mumapurogiramu makumi maviri nemasere akadzidziswa makiriniki, kukanganiswa kwakanyanya kwakaitika muna 7-8% yevarwere, zvichienderana neyedzipi yezvidimbu zviviri zveAteemra zvakashandiswa, zvichienzaniswa ne5% muboka re placebo. Chiitiko chinowanzoitika panguva yekukanganiswa kwaiva nehuwandu (1%). Zviitiko zvinowanzoitika mukati maawa makumi maviri ekuputika kwaiva nemusoro (1%) uye kugadziriswa kweganda (1%). Zviitiko izvi hazvina kukonzera kuregera kana kuregererwa kwemishonga.
- Rituxan (rituximab): Kutungamirirwa kweRituxan kunogona kukonzera kukanganisa, kusanganisira kuurayiwa kwemafuro ekuuraya. Rufu mukati meawa makumi maviri nemaviri eRituxan kuvharwa kwakaitika. Inenge 80% yehutachiona hwekuvhiringidzika kwehutachiona hukaitika pamwe nekubatana kwekutanga.
MuRituxan RA yakarongedza zvidzidzo zvinotungamirirwa ne placebo, kugadziriswa kwakanyanya (fever, chills, rigors, pruritus, urticaria kana rash, angioedema, sneezing, kukanganiswa kwehuro, kukonzera, kana kuti bronchospasm, kana kana pasina hypotension yakagadzikana kana chirwere chepfungwa) yakawana 27 % vevarwere veRituxan vakatevedzerwa nekutakura kwekutanga, vachienzanisa ne19% yeboka re placebo. Chiitiko chekunyanyisa kwakanyanya kwekutevera kwechipiri kukanganiswa kweRituxan kana placebo kunoderera kusvika 9% uye 11%, zvichienderana. Kukanganisa kwakanyanya kwakanyanya kwakawanikwa ne <1% yevarwere mune imwe boka rekurapa.
Dose kuchinjwa kwaidiwa mu 10% yevarwere vanorapwa neRituxan vs. 2% yeboka re placebo.
Kuwirirana Kunowanikwa Mhinduro Dzakasiyana
Nezvinonzi biologic zvinodhaka zvinoshandiswa pasi pemaitiro, kushandiswa kwejw.org kunogona kuitika asi kazhinji hapana kurapwa kunodiwa uye kuregererwa kwemishonga hazvidiwi.
Vatsvakurudzi zvakare vakatarisa dambudziko rekuongororwa kwechipatara kuti vaongorore huwandu hwekujaira kwemajw.org. Kunyange zvazvo inopa pfungwa, yeuka, kuedza kwakasiyana-siyana kwekliniki hakugone kuenzaniswa uye chirwere chekuongorora kliniki hachisi kureva izvo zvinowanzoitika mumutambo chaiwo.
- Enbrel (etanercept): Mune miedzo inotariswa ne-placebo ye rheumatologic conditions, inenge 37% yevarwere vanobatwa neEbrel vakagadziriswa maitiro ekujekesa. Zvose zvinokonzerwa nejw.org nzvimbo dzakarondedzerwa sezvinyoro kusvika pakuenzanisa (erythema, kubvambura, kurwadziwa, kupfupa, kubuda ropa, kuputika) uye kazhinji hazvina kutungamirira kumishonga yekurega. Kupindirana kwemajw.org kunowanzogara mazuva matatu kusvika ku5, kazhinji kwakaitika mwedzi wokutanga uye zvakaderera muhuwandu.
- Humira (adalimumab): Muedzo ye-placebo-controlled, 20% yevarwere vanobatwa neHumira vakagadzirisa maitiro ekusaita majekiseni (erythema, kuchenesa, kuora, kuora kana kupfugama), zvichienzanisa ne14% yevarwere vanowana nzvimbo. Nzira dzakawanda dzekudzivirira nzvimbo yejw.org dzakarondedzerwa sezvinyoro uye kazhinji hazvirevi kuderedza kushandiswa kwezvinodhaka.
- Simponi (golimumab): Mune miedzo inotungamirirwa neChipiri II / III, 3.4% yevarwere vanongorapwa vanove nemafungiro emagadzirirwo ekuenzanisa kana iine 1.5% muboka rinodzora. Nzvimbo dzakawanda dzekujaira kwepajw.org dzaive dzinyoro uye dzisinganzwisisiki, uye kunyanya kuratidzwa kwave kuri erythema.
- Cimzia (certolizumab pegol): Pakanga paine kutaurwa kwekugona kwejojo site site reaction neCimzia muzvinyorwa zvinorondedzerwa, zvinorondedzerwa sevashoma, asi hapana mashoko akawandisa akapiwa.
Sources:
Rheumatoid Arthritis: Kutanga Kurapa uye Kuongororwa. Kushi, Weinblatt, Kavanaugh. 2010. Gwaro rechitatu. Professional Communications, Inc.