FDA Yakagamuchirwa Esbriet uye Ofev yeIdiopathic Pulmonary Fibrosis.
MunaOctober 2014, FDA yakagamuchira mishonga miviri mitsva, pirfenidone (Esbriet) uye nintedanib (Ofev), pakurapa idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis chirwere chinotyisa chinouraya vanhu vazhinji vanorwara pamwe nacho mumakore mashomanana maduku. Pamberi pekuwanikwa kwepirfenidone uye nintedanib, pakange pasina hutano husinganzwisisiki hwekurapwa kwevanhu vane chirwere ichi chinouraya.
Chii chinonzi Idiopathic Pulmonary Fibrosis?
Idiopathic pulmonary fibrosis chirwere chisingaperi kana kwenguva refu chinoparadza nzvimbo duku mukati memapapu (interstitia). Kunyange zvazvo dambudziko risina kuwanikwa riripo pamusoro pekupararira kwechirwere chacho, American Lung Association inofungidzira kuti inorwisa vanenge 140 000 vokuAmerica. Ndichinyanya kuongorora mabhuku, ndakaona zvikamu zvakaderera zvishoma apo chirwere ichi chinotsanangurwa zvakanyanyisa (chinyengetererai pun), uye inobatsira chero kupi zvako kubva kune 14 ne28 vanhu pa100,000. Vanhu vane chirwere vanowanzova nemakore makumi mashanu nekure, uye chirwere ichi chinokanganisa varume vakawanda kupfuura vakadzi.
Hapana anoziva chinokonzera idiopathic pulmonary fibrosis (ndicho chikonzero nei inonzi chirwere chinonzi idiopathic ). Izvo zvatinoziva ndezvokuti chirwere ichi chinouraya chinowedzera kubuda mumapapu-mapapu inhengo yakadzika-ichiita kuti zvive zvakaoma kufema. Panoti, idiopathic pulmonary fibrosis inorambidza chirwere chemapapu chinoderedza mapapu akawanda.
Kana uchangobva kuongororwa, nguva yepakati yekupona kwevanhu vane chirwere ndeyemakore mana chete.
Idiopathic pulmonary fibrosis inokonzera kutuka uye kuchinja kwehutambo (scarring) mumapfupa emapapu (parenchyma) iyo inogadziriswa yakakonzerwa nemapilisari emaploraire mualveoli. Iyo mapurmonary capillaries mu alveoli saka inoparadzwa; mapapirore emapmonari anobatanidzwa mukushandura kweokisijeni uye kujekesa ropa rey oxygen mumuviri.
Mune mamwe mazwi, kune vanhu vane idiopathic pulmonary fibrosis, kuputika mumapapu mumapukisi mumakona ekukwanisa kwemapapuriri emapurisa kuti asvike okisijeni kubva mumhepo yatinofema.
Idiopathic pulmonary fibrosis inoita kuti zvive zvakaoma kufema shure kwekuedza. Inokonzera kukorodzwa uye kuchinja mumapapu mumhanzi pakuongorora. Zviratidzo zvakawanda zvechirwere ndezvehutachiona kana muviri wose, zvakare, uye zvinosanganisira kuneta, kuora kurasika uye clubbing yeminwe nezvigunwe. Kugadziriswa kweC-CT kuongorora (fungidzira über-tsanangudzo x-rays) kuratidzira chidimbu kana kuti "chisikiti" kuonekwa uko kushanduka kwehutano kwakaitika. Kuvhiya biopsy kunopa tsanangudzo yekujekesa yechirwere ichi. Sezvo pulmonary fibrosis ichifambira mberi, inotungamirira kumagariro akawanda anokonzera kana akabatanidza kusanganisira kusakundikana kwekupemha, mwoyo kusakonzerwa uye mishonga yeupemenia .
Kunyangwe tisingazivi kuti chii chinokonzera idiopathic pulmonary fibrosis, tinoziva kuti pane zvimwe zvinogona kuitika kune chirwere ichi:
- fodya fodya
- utachiona hwemapapu zvirwere
- inhalation gas, fumes, guruva nezvimwe zviduku
- GERD (gastroesophageal reflux chirwere AKA chisinganzwisisiki mwoyo)
- genetics
Idiopathic pulmonary fibrosis inonyanya kuzivikanwa nekushayikwa kwayo kwakanaka uye inoshanda.
Kunyange zvazvo vamwe vanhu vakaramba vakasimba kwenguva yakareba mushure mokunge vaongororwa, vazhinji vanobhadhara kana kuti vakaipa kunyange nekurapa. Kurapa ikozvino kune chinangwa chezviratidzo zvechirwere kana kuedza kukonzera kuwedzera kuvhiringidza uye kupora. Prednisone, steroid, inowanzoshandiswa kubatsira kubvisa kuputika. Vanhu vazhinji vane idiopathic pulmonary fibrosis vanogamuchirawo kuwedzera kwemhepo yakakonzerwa nekugadzirisa mishonga. Pakupedzisira, chete nzira yekurapa yevanhu vane idiopathic pulmonary fibrosis isapfu yekuputika.
Chii Pirfenidone (Esbriet) uye Nintedanib (Ofev)?
Mumakiriniki ekuedzwa, pirfenidone (Esbriet) uye nintedanib (Ofev) yakaratidzwa kuti kuderedze fibrosis kana kupera, uye nokudaro kuwedzera kukurumidza kwechirwere.
Pirfenidone ine mikana yakawanda yekuita uye ine mushonga wemuromo. Muchikamu chechitatu chemakirini emakiriniki, inenge hafu yevatori vechikamu vane unyoro kusvika kuenzanisi idiopathic pulmonary fibrosis inogamuchira pirfenidone yakaona kuderera kuderera mukumanikidzirwa kunokosha. Ichi chiyero chinoratidza kunonoka kuenderera mberi kwechirwere. Vatori vechikamu vakaona zvimwe zvikomborero zvinosanganisira kuvandudzwa mumakiromita matanhatu ekufamba-famba uye kuderera mukufa (nhamba yevakafa) panguva yekudzidza kwevhiki-52. Migumisiro yakaipa inogona kuitika yekurapwa yaikwanisa kugadziriswa uye yakagadzikana kune photosensitivity, mimba dzomukati, kushungurudza uye kurutsa.
Nintenanib is tyrosine-kinase inhibitor uye sepirfenidone inorapwa mishonga. Pakati pezvimwe zviitiko zvebiologic, tyrosine kinase inobatanidzwa mukupora uye kushanduka kwemagetsi. Muchikamu chechipiri mishonga yemakiriniki, kufanana nepirfenidone, nintenanib yakaderedzawo kufambira mberi kweidiopathic pulmonary fibrosis sezvakayerwa nekuderedzwa kwechiyero chekuderera kwekumanikidzirwa kunokosha. Zvimwe zvinogona kuipa zvinokonzera kuora, kusuruvara, kusuruvara, kuora musoro, kuwedzerwa kweropa, uye kuwedzerwa maonde enzymes (chinoratidza chiropa chisingaiti). Pakupedzisira, Ofev isatatogen iyo haifaniri kutorwa panguva yekuzvitakura nokuda kwekutya kwe fetal deformity kana kufa.
Chii Pirfenidone (Esbriet) uye Nintedanib (Ofev) Inoreva Kwauri?
Kana iwe kana mumwe munhu waunoziva ane idiopathic pulmonary fibrosis, kugamuchirwa kwepirfenidone (Esbriet) uye nintedanib (Ofev) Inguva yezvokurapa iyo inofanira kugamuchirwa semashoko akanaka. Zvisinei, dzimwe nyaya dzinoda kujekeswa vasati mishonga iyi ichitsvaga nzvimbo yavo mune mishonga yekliniki. Chokutanga, hazvisi pachena kana pirfenidone uye nintendanib inofanirwa kushandiswa zvakasiyana kana panguva imwechete pakurapa idiopathic pulmonary fibrosis. Kana ikashandiswa pamwe chete, hatina chokwadi kuti chirwere chipi chinofanira kushandiswa kutanga. Kana ikashandiswa zvakasiyana, hatina chokwadi kana mishonga icharatidza kusangana kana kuwedzererwa. Chechipiri, hatina chokwadi kana vamwe vanhu vari kunyanya kuteerera ("responders") kune imwe kana maviri aya mishonga. Chechitatu, hatizivi kana madhiragi acharamba achiedza kuderedza kufambira mberi kweIdiopathic pulmonary fibrosis yapfuura gore rinosvika gore.
Pamusoro pekupedzisira, kana iwe kana munhu waunoda ane idiopathic pulmonary fibrosis, funga kudzidza zvakawanda pamusoro pemapoka ekutsigira chirwere paAmerica Lung Association kana National Heart, Lung, uye Blood Institute.
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