Zvinyorwa zvinoenderana neMesipiringiro yeTrapeing uye Primary-Progressive MS
Iko monoclonal antibody Ocrevus (ocrelizumab) inonzi FDA-inogamuchirwa mukurapa zvose zviviri zvinoenderera mberi MS nekudzokazve marudzi eMS. Ichi ndicho chikuru cheM MS kuputsa, sezvo pane iye zvino hapana imwe mishonga yekurapa vanhu vane zvirwere zvokutanga zvinowedzera.
Chii Chinonzi Ocrevus?
Ocrevus (ocrelizumab) inonzi humocidal monoclonal antibody inosungira kumusero inodanwa CD20, inenge iri pamusoro pemasero eB (rudzi rwechirwere chemuviri chechivi).
Nokusungira kuCD20, nhamba yemasero eB inoderera muropa remunhu.
Sezvo masero eB achiita basa mu myelin sheath kurasikirwa uye kukanganisa mune multiple sclerosis, kuparadza aya masero eB akaratidzirwa kuderedza chirwere cheMMS. Izvo zvataurwa, nokuti Ocrevus chete zvinokonzerwa nemamwe masero B, mamwe masero mukati memumasimba ezvirwere (semasero eT) anoramba asina kumira, achibatsira kuchengetedza muviri wemunhu.
Ocrevus mu Phase III Miedzo MS
Ocrevus yakaongororwa mumatatu matatu echitsauko chekurapa zvose zvekudzorera zvakare MS uye chekutanga MS. Mune miedzo miviri, Ocrevus yakafananidzwa naRebif yekurapa vanhu vanezve zvakare-kutendera MS. Kubvira pane ikozvino hapana mishonga inogamuchirwa neDAA yekutanga-inofambisa MS, Ocrevus yakafananidzwa ne placebo muidzo iyo.
Chiyeuchidzo chiduku-apo mutsara wechipiri II inotsvaga kuchengetedza uye kubatsirwa kwechirwere, mitezo yechitatu III yakawanda uye inofananidzwa nemishonga kusvika muzinga rekuchengetedza mishonga.
Kurapa Kudzokorora MS NeOcrevus
Muchikamu chechipiri miedzo yevanhu vane kudzoka kweMMS, vanopfuura 1600 vatori vechikamu vakashandurwa kuti vawane kana Ocrevus infusion mumwedzi mitanhatu kana Rebif (interferon beta-1a) katatu vhiki nevhiki kwemavhiki 96 (anenge makore maviri). Rebif iyi inonzi injection subcutaneous, zvinoreva kuti inopiwa pasi peganda neine tsono shoma.
Mhinduro yakaratidza kuti kuchinja kwegore negore kwakange kuri 46 kusvika 47 muzana kubva pasi kune vatori vechikamu avo vakagamuchira Ocrevus kupfuura kune avo vatora vakagamuchira Rebif. Mukuwedzera, kufambira mberi kwekuremara kwevatori vechikamu kwakaenzana pamasvondo gumi nemaviri nemasvondo makumi maviri nemaviri achishandisa EDSS .
Muzvikamu zviviri zvenguva, vatori vechikamu vakagamuchira Ocrevus vaiva nekuwedzera kwekuremara kwepamusoro kune avo vakagamuchira Rebif.
Uyewo, pane 94 kusvika kuzana 95 kubva muzana gadolinium-enhancing lesions kuMRI muboka reOcrevus kupfuura rebif boka.
Zvinosvibisa miitiro iyi miviri miviri yaisanganisira:
- Kugadziriswa kwehutachiwana muboka reOcrevus (mune zvishoma chikamu chetatu chevatori vechikamu): kufanana nekuputika, kuputika, kana tsvina
- Zvirwere zvakakomba zvakaitika muna 1.3 muzana yevaya vari muboka reOcrevus uye 2.9 muzana muboka reRebif
- Zvitsva, zvisingasviki zvisikwa zvakakura (zvinonzi neoplasms) zvakaitika mu 0.5 muzana yevaya vari muboka reOcrevus uye 0.2 muzana muboka reRebif.
Kubata MS-Primary Progressive MS neOcrevus
Muchikamu chechitatu chekuedzwa kweOcrevus mumusangano wekutanga-progressive MS (PPMS), vanopfuura 700 vakapinda vakagamuchira Ocrevus kana kuti placebo infusion mumwedzi mitanhatu kwevhiki dzinenge 120.
Zviitiko zvakaratidza kuti pamasvondo gumi nemaviri, pakanga paine kuderedzwa kwemazana makumi maviri kubva muhutano hwekuremara kwekuremara kune avo vakatora avo vakagamuchira Ocrevus, kusiyana nevaya vakagamuchira placebo kuiswa.
Pamasvondo makumi maviri nemana, kupindira kwekuremara kwakagadziriswa kwakaderedzwa 25 muzana muvatori vechikamu vakatora Ocrevus.
Ocrevus yakawanikwawo nekuderedza nguva yaidiwa kuti vatori vechikamu vafambe mamita makumi maviri nemapfumbamwe kubva muzana kana vachienzaniswa ne-placebo infusion.
Pahuropi MRI, mushure memavhiki makumi maviri nemaviri, pane mazana 3.4 muzana pasi pehuwandu huwandu hweT2-hyperintense zvipembenene zvehupi muboka reOcrevus rinopesana ne7,4 muzana mavhungiro muboka re placebo.
Mukutaura kwemigumisiro yakaipa, boka reOcrevus raive nemafungiro akawanda ekuputika, maitiro ekudzivirira kuputika kwezvirwere, uye muromo wemaperembudzi herpes . Kukanganisa kwakabatana-kufanana (kufambisa, kuchenesa, kuputika, uye kuputika kwehuro) zvaive zvakajairika mushure mokunge kuvharwa kwekutanga uye kuvandudzwa nemitengo inotevera.
Zvirwere zvakakomba zvakaitika muna 6.2 muzana yeboka reOcrevus uye 5.9 muzana yeboka re placebo-rakafanana mumapoka ose maviri. Vatsvakurudzi vakanyatsorondedzera kuti chirwere chikuru chakadini-chirwere chinouraya, kutyisidzira upenyu, chaidiwa kuchipatara, chakaguma nekuremara, kana kuchida kurapwa kwechiremba (semishonga inorwisa mabhakitiriya) kudzivirira kufa kana kuremara.
Zvinonakidza kuona kuti pane maharapopi akawanda muboka reOcrevus (sekuita sepamuti uye kenza yeganda) kupfuura boka re placebo. Hazvizivikanwi kuti nei ichi chiri ichocho uye mvumo yekuongorora zvakare.
Shoko Rinobva
Ocrevus (ocrelizumab) ndiyo mishonga yekutanga yeAIDS-yakagamuchirwa kubata mushonga wokutanga weSMS, iyo inobata anenge 10 kusvika ku15 muzana yevanhu vane MS, saka izvi zvinonakidza zvikuru uye zvinotarisira. Zvechokwadi, zvinonakidza zvakare kune avo vanezvezvezve maitiro eMS, sezvo vanhu vakawanda vakaramba vachikura nekudzokazve pasinei nekurapa kwezvino MS. Ocrevus ikozvino inovapa imwe imwe nzira.
Izvi zvose zvinotaurwa, zvakakosha kuyeuka kuti kusarudza yakakodzera MS kurapwa kwako ndiyo yakashata uye yakasarudzwa. Mukuwedzera, migumisiro yemitatu mitatu iri paOcrevus hairi kufanotaura kuti iwe uchapindura sei kumishonga.
> Sources:
> Hauser SL et al. Ocrelizumab neAferferenta Beta-1a mukudzokororazve multiple sclerosis. N Engl J Med . 2016 Dec 21.
> Montalban X et al. Ocrelizumab neusapibo mu primary primary multiple sclerosis. N Engl J Med. 2016 Dec 21.
> Sorensen PS, Blinkenberg M. Inogona kuita basa re ocrelizumab mukurapa multiple sclerosis: ikozvino uchapupu uye tariro yeramangwana. Ther Adv Neurol Disord . 2016 Jan; 9 (1): 44-52.