Kutanga JAK Inhibitor yeRheumatoid Arthritis Inogamuchirwa neDDA
Xeljanz (tofacitinib citrate), inonzi DMARD (chirwere-chinorwisa anti-rheumatic drug), yakagamuchirwa neU.S. Food and Drug Administration (FDA) musi waNovember 6, 2012. Chirwere chacho chinotarisirwa kuti kurapwa kwevanhu vakuru vaenzanise- zvakakomba-zvinoita rheumatoid arthritis iyo yakange isisina kukwana, kana kusagamuchirwa, ku methotrexate . Yakaumbwa nePfizer, Xeljanz inotenderera, yakachena, yakasununguka-yakasununguka, ipirati yakavharwa nefirimu ine "Pfizer" kune rumwe rutivi, uye "JKI5" yakanyorwa kune rimwe divi.
Xeljanz ndiye wekutanga DMARD wemuromo wakagamuchirwa nehutatoid arthritis mumakore gumi. Ndiyo yekutanga mukirasi mutsva yemishonga inozivikanwa seJAK (Janus kinase) inhibitors. Xeljanz inogona kushandiswa se monotherapy (yoga), kana kusanganiswa ne methotrexate kana mamwe maDMARD asingasviki. Xeljanz haifaniri kushandiswa nemishonga ye biologic kana simba rekudzivirira zvirwere, semu Imuran (azathioprine) kana cyclosporine .
Iyo Inoshanda Sei
Chaizvoizvo, Xeljanz inoshanda nekudzivisa nzira yeJAK - nzira yekucherechedza mukati memasero anoita basa rinokosha mukuputika kunobatanidza nerheumatoid arthritis. JAKs is intracellular enzyme iyo inotumira zviratidzo zvinomuka kubva ku cytokine kana kukura kwezvinhu-receptor kushandiswa pane membrane yesero.
Xeljanz inofungidzirwa sediki-molecule mishonga, kwete biologic drug. Biologics, dzakadai seEnbrel (etanercept), Remicade (infliximab), Humira (adalimumab), Cimzia (certolizumab pegol), Simponi (golimumab), Orencia (abatacept), Actemra (tocilizumab), uye Rituxan (rituximab) chivako chinonzi pro-inflammatory cytokines kubva kunze kwechitokisi.
Clinical Trials Performance
Vanopfuura 5,000 rheumatoid arthritis varwere vaibatanidzwa mumakiriniki ekuongorora zvipatara zve Xeljanz, zvichiita imwe yeiyo yakakura yekliniki yemadhishopu chero ipi zvayo yerumatoid arthritis drug yakamboiswa kune FDA kuti iongorore, maererano naPfizer.
Paiva nemakirini maviri emakiriniki akaongororodza maitiro akaenzana eXeljanz, uye mishonga 5 yemakirini yakaongorora mhinduro ye ACR 20 kuXeljanz, pamwe neDAS28 uye Health Assessment Questionnaire mhinduro.
Mishonga yemakiriniki yakaratidza kuti Xeljanz yakaderedza zvikuru zviratidzo nezviratidzo zve rheumatoid arthritis nekuvandudzwa kwemuviri (basa rekuita mabasa ezuva nezuva).
Dosage
Xeljanz inotorwa nemuromo, 5 mg piritsi inotorwa kaviri zuva rimwe nerimwe. Inogona kutorwa pamwe kana kuti isina zvokudya. Chirwere che 11 mg kamwe-zuva nezuva chinowanikwawo zvino se Xeljanz-XR (yakasunungurwa yakasunungurwa).
Nharaunda Dzakabatana
Matambudziko anowanzovhiringidza akabatanidzwa neXeljanz, akaitika mukati memwedzi mitatu yekutanga yekushandiswa mumakiriniki emakiriniki, aiva nepamusoro ekudzivirira kuputika kwezvirwere, kushaya musoro, chirwere, uye nasopharyngitis.
Manyevero uye Kuchengetedza
Xeljanz inotakura nyevero inonzi boxed : zvirwere zvakakomba zvinotungamirira kuchipatara kana kufa, kusanganisira tuberculosis uye mabhakitiriya, fungi inowedzera, viral, nezvimwe zvirwere zvinotarisana, zvakaitika kune varwere vanogamuchira Xeljanz; kana chirwere chakakomba chichikura, Xeljanz inofanira kumira kusvikira utachiona hwave huchitungamirirwa; chirwere chinonzi latent tuberculosis chinofanira kupiwa musati watanga Xeljanz; varwere vanotora Xeljanz vanofanira kuongororwa kuti vabate chirwere chetachiona kunyange kana kuongorora kwekutanga kusina kunaka; lymphoma nezvimwe zvirwere zvinoratidzirwa zvakaonekwa muvarwere vachitora Xeljanz; "Epstein Barr Virus-associated lymphoproliferative disorder" yave ichionekwa mukurapa kwechirwere varwere vanorapwa neXeljanz pamwe chete nemishonga inoratidzira maitiro.
Zvimwe zvinodzivirira: shandisa Xeljanz nekuchenjerera kune varwere vari panjodzi yekugadzika kwepamuviri; Xeljanz haigamuchirwi kune varwere vane chirwere chakaipa cheropa; periodic laboratory tests inokurudzirwa nokuti Xeljanz inogona kukonzera kuchinja kune mamwe marudzi emasero machena eropa, hemoglobin, enzyme yechiropa , uye lipids; varwere vanotora Xeljanz havafaniri kugamuchira zvirwere zvinorarama.
Zvidzidzo zvakakwana zve Xeljanz vakadzi vane pamuviri havana kumboitwa. Xeljanz inofanira kushandiswa chete panguva yekuzvitakura kana kubatsirwa kwechirwere ichi kuchikwanisa kuisa njodzi kumucheche.
Zvinodhura
Xeljanz ichava nemari yakawanda yekuwana mari ye $ 2055.13 kwemazuva makumi matatu (kana $ 24,666 pagore).
Mutengo wevarwere uchasiyana zvichienderana nezvibvumirano uye inishuwarenzi.
> Sources:
> Xeljanz. Kunyatsorondedzera Mazano uye Mazano Okurapa. Revised 02/2016.
> US Food And Drug Administration Inobvumirana nePfizer's XELJANZ (tofacitinib citrate) yeVakuru neVanenge Vachiita Nesimba Zvakanyanya Rheumatoid Arthritis (RA) Ndiani Akange Asina Kururamisa Zvisina Kukodzera kana Kusagadzikana kuMethotrexate. 11/06/2012.
> Xeljanz, A-Asi-Inodhura $ 25,000-A-Year Pfizer Piritsi yeRheumatoid Arthritis, Inowana FDA Green Light. Matthew Herper. Forbes.com. 11/06/2012.