Novantrone (mitoxantrone) uye Tysabri (natalizumab) zvose zviri zviviri zvinoshandiswa mumamiriro ezvinhu akafanana ekurapa multiple sclerosis - kune vanhu vanowedzera kuorazve-remitting multiple sclerosis (RRMS) kana kuti progressive-relapsing multiple sclerosis (PRMS). Novantrone inoratidzirwa kune yechipiri-progressive multiple sclerosis (SPMS), uye Tysabri inogona kubatsira mumamiriro ezvinhu eSMS apo zvironda zvinoshanda zvinoramba zvichiratidzwa neMMIs, zvakare.
Hapana chimwe chekutanga-MS chinopfuurira.
Izvi zvinoreva kuti vanhu vazhinji vane imwe yemhando idzi dze MS vane sarudzo yekuita: Tysabri kana Novantrone. Kunyange zvazvo zvingava zvakanaka kudai mumwe munhu ane ruzivo rwakakura kune rumwe mune zvose, izvi hazvisizvo. Kufanana nezvimwe zvose neMS zvinoratidzika kuva, Tysabri vs. Novantrone chisarudzo chakavakirwa pane boka rezvinhu zvakaoma. Chisarudzo chinofanira kunge chakavakirwa pane zvaunoda uye mararamiro ako, chiremba kukurudzira uye kuwanika, uye zvimwe zvinhu zvakadai sekubhadhara, kutya kwemigumisiro yakananga uye kuongorora zvinodiwa.
Muchikamu chino, ndakaita zvakanakisisa kuti ndienzanise Tysabri neNovantrone pamwe-ne-kurutivi pane zvakawanda zvezvikamu zvehutano izvo ini ndinoziva kuti vanhu vanofarira zvikuru. Regai nditaure kuti mishonga iyi yese ine nzira yakasiyana-siyana yekuita , saka hazvirevi kuti kana mumwe mushonga unoita basa rawo "zviri nani" - vanoita zvinhu zvakasiyana, asi nechinangwa chimwechete chekudzikisa kupererwa kwekuremara nekudzivirira MS kudzoka zvakare.
Tysabri inonzi monoclonal antibody inodzivirira mamwe T-seli kuti arege kuyambuka ropa-brain, asi Novantrone is chemotherapy inoderedza basa rekudzivirira muviri.
Heano zvimwe zvinhu zvaunofanira kufunga paunenge uchisarudza kwako:
Dhigirii Wako Kuwana uye Zvakaitika
Vanachiremba chete vanyoreswa neTOUCH chirongwa chekuona vanogona kupa Tysabri.
Vanhu vazhinji avo chiremba avo vasingakwanisi kuwana Tysabri vanopedzisira vachinjira kune nyanzvi yezveuropi iyo inokwanisa kuwana. Cheropi chiremba anogona kupa Novantrone, zvisinei, zvinokurudzirwa kuti zviitwe nachiremba ane ruzivo pakuongorora nekutarisira varwere vanowana chemotherapy yehupenyu huno.
Migumisiro Yechipfuva nekuchengeteka
Kunyange zvazvo zvinyorwa zvengozi zveTysabri neNovantrone zvakasiyana zvachose, zvose zvinokonzera kutanga kusakanganisika kana kutya kwevanhu vazhinji - Tysabri ine nhoroondo yeP PML neNovantrone is chemotherapy. Heino inguva yakagadziriswa - Novantrone inogona kukuita iwe unzwe uine hunyoro mushure mekudzivirira kwemazuva mashomanana, nezvinhu zvakadai sekurutsira / kunyorera, kuwedzerwa njodzi yemukaka uye kuputika kwezvirwere, uye, zvakanaka, unogona kurasikirwa vhudzi rako. Pamusoro peTysabri, pamwe haungati uchinzwa zvakakomba mumazuva anotevera kukanganiswa, sezvo zvinowanzovhiringidza zvinokonzerwa nekuderedza-nzvimbo, kuneta, misoro nemarwadzo. Ichisarudzo chekuti vanhu vazhinji vanogona kuwira pakusarudza pakati pe (1.2 ne10 000) ngozi ye PML neTysabri maererano nehutachiwana hwehuukemukari (7.4 pa1 000) kana kukuvara kwemwoyo neNovantrone.
Frequency
Tysabri inotarisirwa mukati-kati (ne IV mune imwe nzvimbo inopindira kana muhofisi yechiremba) kamwechete pamwedzi.
Novantrone inotarisirwa intravenously mwedzi mitatu yose.
Kushandiswa kwenguva refu
Tysabri (panguva ino nenguva) inogona kushandiswa nekusingaperi, kunyange zvazvo kuchengetedzwa kwemishonga pashure pemakore maviri ekushandisa kusingazivikanwi. Novantrone, kune rumwe rutivi, inogona kushandiswa chete kusvika kumakore maviri kusvika matatu (gumi kana gumi nematanhatu emitengo yakazara) muhupenyu hwomurwere.
Kubudirira
Kubudirira kwezvinodhaka kunoratidzika kunge kwakafanana, asi zvakaoma kuenzanidza zvakananga, nekuda kwekusiyana kwekugadzira kudzidza. Muchidzidzo chemakore maviri, ichienzaniswa ne placebo, Novantrone yakaratidzwa kuderedza nhamba yekudzokazve , inowedzera nguva pakati pekudzokazve, inoratidza kupera kwemazana makumi mashanu ekuderera kwevadzidzi vechidzidzo kukwanisa kufamba uye nekuremara kwepfungwa dzisina ruzivo.
Tysabri yakaratidza kuderedzwa kwe 68% mukudzokazve kwemakore maviri, pamwe nekuderedza kufambira mberi kwekuremara nekuderedza nhamba yekudzoka patsva.
Kubata (Current and Future) uye Breastfeeding
Vakadzi vane pamuviri kana kuedza kubata pamuviri havafaniri kutora kana Tysabri kana Novantrone, uye havafaniri kushandiswa nevakadzi vanoyamwisa. Tysabri inonzi inenge iri "pamuviri wechikamu C," zvinoreva kuti yakakonzera kukuvadza kune fetusi muzvidzidzo zvemhuka asi kuitika kwevanhu hakuzivikanwi. Tysabri inofanira kumira kwechinguva asati aedza kuve nemimba (kazhinji mwedzi miviri kusvika kune matatu: kurukura izvi nechiremba wako). Novantrone inofungidzirwa kuti iri mu "chikwata chechikwata Chechi D," zvinoreva kuti zvinogona kukonzera kukuvadzwa kwekuberekwa kana zvichiitwa kumukadzi ane pamuviri. Vakadzi venguva yekubereka vanoda miviri yekudzivirira vasati vagamuchira chiyero cheNovantrone.
CHIKAMU CHINOKOSHA: Vamwe vakadzi (5-30%) vanopedza nguva yakazara yeNovantrone havamboiti nguva yavo zvakare uye havana maturo (vasingakwanisi kutora pamuviri). Zvinonyanya kukosha kuti uone izvi zvichiitika kana ukasarudza kana usingashandisi Novantrone uye kuti uchitaurirane nemurume wako kana shamwari yako. Zvidzidzo zvenguva pfupi zvinoratidza kuti mukana wevakadzi vasina simba unogona kuderedzwa nekushandiswa kwemishonga yehomoni (estroprogestinic zvinodhaka) panguva yekurapwa neNovantrone uye izvi zvinofanira kukurukurwa nachiremba wako.
Solu-Medrol
Solu-Medrol, iyo intravenous corticosteroid iyo inoshandiswa kupfupisa nguva uye kuoma kwekudzoka zvakare, haisati yakakurudzirwa kune vanhu vari kushandisa Tysabri kwemwedzi mwedzi isati yasvika kana kuti mushure mekunge kuvharwa kwekupedzisira, nekuda kwekuwedzera kwekudzivirira muviri, kunyange kune vamwe vanachiremba vanozozvigadzirisa pakudzokorora zvakare uye ndakanzwa nezvemaitiro asinganzwisisiki (125 kusvika 500 mg) anopiwa panguva imwechete seTysabri infusion kuti ibatsire nehutachiona hwehutachiona hweTysabri. Kune rumwe rutivi, Solu-Medrol inowanzopiwa panguva imwecheteyo seNovantrone infusion uye inogona kupiwa pachena pamamiriro ekudzokazve pakati peNovantrone infusions.
Kuongorora
Usati watanga Novantrone, iwe uchatora miedzo inotevera: kuongorora ropa (CBC, chiropa chebasa, kuberekwa kwevakadzi), electrocardiogram (EKG), uye echocardiogram seongororo yekutanga yechinyamu chinokonzera chinonzi ventricular ejection fraction (LVEF) inofanira kuitwa musati wese yeNovantrone. Novantrone kurapwa kunofanira kubviswa kana LVEF ichichinja zvikuru kana iri pasi pe50%. Maedzo ose achadzokororwa vasati vatapwa. Tysabri inogona kugoverwa pane imwe nzvimbo yekuisa pasi iyo yakanyoreswa kuburikidza ne "TOUCH" purogiramu. "TOUCH" inomiririra "Tysabri Outreach: Unified Commitment to Health" uye ndiyo chirongwa chakaiswa panzvimbo yekuedza kubata chero zviitiko zvinogona kuitika zve PML mumavambo okutanga, pamwe nekudzivirira. Iwe uchaongororwa nachiremba kana mukoti uye unotora MRI usati watanga Tysabri, ndokuzoongorora mwedzi mitatu kusvika kumwedzi mitanhatu nokuda kwekuchinja kwehutano. Iwe uchabvunzwa kuti uongorore ruzivo rwehutano hwekuchengetedza uye uzadze pfupiso shomanana mushure mekunyudzwa kwese.
Contraindications
Novantrone haifaniri kushandiswa nevanhu vane chirwere chepfungwa kana kutora mamwe mishonga inogona kukuvadza mwoyo, zvinetso zvechiropa, zviduku zvakatsvuka uye vatsvene ropa, zvinetso zvekuvhara ropa, kenza kana nhoroondo yemakwenzi ekurapa apfuura. Tysabri haafaniri kutorwa nevanhu vari kutora immunosuppressants kana immunomodulator kana nevanhu vane maitiro ekudzivirira zvirwere. Uyewo kushandisa zvinodhaka kunofanira kutorwa nevanhu vane zvirwere zvemazuva ano.
Mutengo
Tysabri ndeimwe yemari inodhura zvikuru yemishonga yeMMS inowanika, pa $ 28,400 pagore reTysabri pacharo. Novantrone inodhura madhora 3 000 pagore pamishonga, zvichiita kuti isanyanya kudhura. Zvose izvi zvinouya nezvimwe zvinodhura zvekuderedza nzvimbo.
Pasi Pasi
Chisarudzo chekushandisa Tysabri kana Novantrone ndechokuti iwe pachako, iyo inogona kuva iri nyore kana yakaoma, zvichienderana nezvinhu zvipi zvaunofungidzira kana zvinoshanda kwauri (somuenzaniso, mumwe munhu anofanira kubhadhara muhomwe angawana Novantrone zvakanyanya inofadza, nepo musikana wechidiki anoda vana mune ramangwana anganamatira zvikuru kuna Tysabri). Kana chiremba wako ane maonero ane simba nenzira imwe neimwe, iva nechokwadi chokuti iwe unomukumbira kuti atsanangure zvikonzero. Nguva dzose unzwe wakasununguka kuwana imwe maonero kana iwe uchigere kugutsikana. Zvinogona kuva kuti chiremba wako haafaniri kuwana Tysabri - kana uchida, tsvaga mumwe chiremba unoita uye kumubvunza maonero ake. Kusiyana neizvi, zvinogona kuva kuti chiremba wako haanzwisisiki kushandisa chemotherapy madhiragi, asi pane vamwe vanachiremba vakawanda vakashandisa Novantrone mumazana evarwere vane zvibereko zvakanaka. Ramba uchitsvaka mhinduro kusvikira wagutsikana.
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