Kusanganiswa Kwemishonga Inopa Zvikwereti Zvakanyanya Kurapa kweGenotype 1 uye 4 Utachiona
Kurongwa
Zepatier (elbasvir / grazoprevir) chirwere chinogadziriswa chinoshandiswa nemishonga inoshandiswa mukurapwa kwehutachiona hwehutachiona hweHpatitis C (HCV) . Mishonga mbiri iyo inosanganisira Zepatier (elbasvir, grazoprevir) basa nekuvhara zvose mapuroteni (NS5a) uye enzyme (NS3 / 4a protease) inokosha pakudzokorora kwehutachiona.
Zepatier yakagamuchirwa musi waJanuary 28, 2016 neU.S. Food and Drug Administration (FDA) iyo inoshandiswa kune vanhu vakuru kwemakore gumi nemana kana kupfuura neHCV genotype 1 kana 4 utachiona , kusanganisira avo vane chirwere chepirhosis.
Inogamuchirwa kuti ishandiswe mune zvose zvisingateereri (kurapa-naïve) kana yakambotapwa (varwere-vane ruzivo) varwere, zvichienderana neHCV genotype uye mamiriro ekurapa.
Efficacy
Zepatier inonzi ine chirwere chisingaenzaniswi muZvipiri II miedzo yevanhu. Hure yeHCV inorondedzerwa sekutsigira hutachiona hwehutachiona husingaoneki kwemavhiki makumi maviri nemashure mokupera kwerapi (inozivikanwawo sekutsigirwa virologic response, kana SVR ).
Izvo zvikamu zveSVR zvakatengesa kubva ku 94% kusvika ku 97% kune varwere vane HCV genotype 1 utachiona, apo varwere vane chirwere chekuberekwa kane genotype vakaudzwa kuti vane SVR mamiriyoni e 97% kusvika 100%.
Dosage
Rimwe piritsi (50mg / 100mg) inotorwa zuva nezuva kana kuti isina zvokudya. Mahwendefa eZepatier akave akafanana-akave akafanana, akaveza-mavara uye mafirimu-akavezwa, ane "770" akaiswa pamativi ose.
Kunyora Zvikurudzira
Zepatier inorayirwa kana kuti kana pasina ribavirin ye genotype 1 kana 4 utachiona. Kusiyana nehutano hweHCV dzakapfuura, peginterferon (chirwere chinosangana nechekare chisingaregi kushanda) hachidiwi.
Usati watanga kurapwa, mazita ekuongorora maitiro anogona kuitwa kuti aone kana iwe une rudzi rwehutachiona husingawirirani neElbasvir chikamu cheZepatier (inozivikanwa seSNS5a-inosanganiswa nepolymorphism).
Nguva yekurapa mahara kubva mavhiki 12-16, zvichienderana neHCV genotype uye mamiriro ekurapa.
| Genotype | Mamiriro ekurapa | Kutorwa ne ribavirin? | Nguva |
| Genotype 1a | chirwere-naïve pasina elbasvir-isingaiti utachiona | aihwa | Vhiki 12 |
| chirwere-naïve ne elbasvir-resistant utachiona | ehe | 16 masvondo | |
| yakambobatwa ne ribavirin + peginterferon pasina elbasvir-resistant virus | aihwa | Vhiki 12 | |
| yakambobatwa ne ribavirin + peginterferon ne elbasvir-resistant virus | ehe | 16 masvondo | |
| yakambobatwa ne ribavirin + peginterferon + neHCV protease inhibitor | ehe | Vhiki 12 | |
| Genotype 1b | chirwere-naïve | aihwa | Vhiki 12 |
| yakambobatwa ne ribavirin + peginterferon | aihwa | Vhiki 12 | |
| yakambobatwa ne ribavirin + peginterferon + HCV protease inhibitor * | ehe | Vhiki 12 | |
| Genotype 4 | chirwere-naïve | aihwa | Vhiki 12 |
| yakambobatwa ne ribavirin + peginterferon | ehe | 16 masvondo |
* - Olysio (simeprevir), Victrelis (boceprevir), Incivek (telaprevir)
Nharaunda Dzakabatana
Maitiro akawandisa anowanzobatanidzwa neZepatier use (inowanikwa mune vanopfuura 5% varwere) ndei:
- Kuneta
- Headache
- Nausea
Kana yakashandiswa ne ribavirin, inowanzoburwa maitiro emishonga (inowanikwa mune varwere vanopfuura 5%) inosanganisira:
- Headache
- Kuneta
- Anemia
- Nausea
- Itchiness
- Indigestion
- Kupfupika kwemhepo
- Kunyunyuta
- Uturu hunorwadza
- Kuderedza kudya mwoyo
- Kukosora
- Kusvibiswa
- Mapundu
Kubatana Kwemishonga
Iyi mishonga inotevera haifaniri kushandiswa pakutora Zepatier sezvo inogona kukonzera kukanganisa kukuru kwezvinodhaka-zvinodhaka:
- Antibiotics: nafcillin
- Anticonvulsives: Dilantin (phenytoin), Tegretol (carbamazepine)
- Antifungals: Nizoral mapiritsi (ketoconazole)
- Anti-hypertensive drugs: Tracleer (bosentan)
- Mishonga yemishonga: St. John's Wort
- VHIV antiretroviral drugs: Aptivus (tipranavir), Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide), Intelence (etravirine), Invirase (saquinavir), Kaletra (lopinavir, ritonavir), Prezista (darunavir), Reyataz (atazanvir), Stribild ( elvitegravir, cobicistat, emtricitabine, tenofovir disproxil), Sustiva (efavirenz),
- Immunosuppressant zvinodhaka zvinoshandiswa kudzivirira nhengo kudyidzana kurambwa: cyclosporine
- Rifampin-based drug used in tuberculosis treatment: Mycobutin, Priftin, Rifater, Rifamate, Rimactane, Rifadin
Kurapa Kufungidzirwa
Izvo zvataurwa mumakiriniki ekuongorora kuti 1% yevarwere vari muZepatier yakagadzirisa kukwirira kwakanyanya kwevhuviri hwechiropa zvinoratidza chiropa chekutyisa, kazhinji kana kana mushure mevhiki yechisere yerapi. Sezvo zvakadaro, kuongororwa kweropa kunokonzerwa nechiropa kunofanirwa kuitwa musati watanga kurapwa uye nguva dzose munguva yeHCV chirwere.
Zepatier haafaniri kutarisirwa kune varwere vane chirwere chakakomba chechiropa.
Kushandiswa kwe ribavirin kunopesana nekamuviri uye haufaniri kunyoreswa kana neZepatier kana chero imwe mishonga yeHepatitis C. Vachirwere vechikadzi vari kurwarisa-ribavirin-based vanofanira kurairwa kuti vasave nepamuviri uye vanoshandisa maitiro maviri asingaiti mahomoni ekudzivirira kubata pamuviri panguva yekurapa uye kwemwedzi mitanhatu mushure mokupera kwerapi.
Kunobva:
US Food and Drug Administration (FDA). "FDA inobvumira Zepatier kuti irapwe chirwere chisingaperi chine hepatitis C chigadzirwa 1 uye 4 zvirwere." Silver Spring, Maryland; kudhinda kusunungurwa kwakabudiswa naJanuary 28, 2016.
Merck. "Zepatier - Highlights of Defcribing Information." Kenilworth, New Jersey; yakasvika musi waJanuary 29, 2016.