Oral Treatment for Psoriatic Arthritis uye Psoriasis
Musi waMarch 21, 2014, FDA yakaratidza kugamuchirwa kwaOtezla (apremilast) yekurapa maitiro anoshanda psoriatic arthritis kuvanhu vakuru. Otezla is selective inhibitor ye phosphodiesterase-4 (PDE4). Otezla ndiyo chete inopupurirwa mumuromo weDAA inogamuchirwa kunyanya ye psoriatic arthritis. Musi waSeptember 23, 2014, FDA yakagamuchira Otezla nokuda kwechimwe chiratidziro, kurapwa kwevarwere vane muongorori kusvika kune zvakanyanya psqueasis iyo iyo iyo phototherapy kana chirongwa chetachiona chakakodzera.
Isati yatenderwa naOtezla, psoriatic arthritis yaiwanzobatwa ne corticosteroids , TNF blockers , kana Stelara (ustekinumab ) , interleukin-12 / interleukin-23 inhibitor yakagamuchirwa munaSeptember 2013.
Otezla Inotungamirirwa Sei?
Otezla inouya semadhipa akaumbwa nemadhaimani, mahwendefa akafukidzwa nefirimu mumasimba matatu: 10 mg, 20 mg, uye 30 mg. Nhamba yekutanga yeOtezla inosanganisira titration kubva pazuva 1 kusvika pazuva 5 kusvika kune yakakurudzirwa kuchengetedza chirwere che 30 mg. kaviri zuva roga roga kutanga pamusi wekutanga 6. Inowanzo titration purogiramu ndeyi:
Zuva 1: 10 mg. pamangwanani
Zuva 2: 10 mg. mangwanani uye 10 mg. manheru
Zuva 3: 10 mg. mangwanani uye 20 mg. manheru
Zuva 4: 20 mg. mangwanani uye 20 mg. manheru
Zuva 5: 20 mg. mangwanani uye 30 mg. manheru
Zuva 6 uye mberi: 30 mg. mangwanani uye 30 mg. manheru
(Cherechedza: Varwere vane hutachiona hwekushaya simba hunodikanwa vachada kugadziriswa purogiramu yeiyo).
Ndezvipi Zvikamu Zvakafanana Zvose Zvave Wakabatana naOtezla?
Mumakiriniki, miviri, kuora musoro, uye kushungurudzika ndizvo zvakanyanya kuonekwa nemigumisiro inosangana neOtezla. Zvakawanda zvezviitiko zvinotambudza zvakaitika mukati mavhiki maviri ekutanga ekurapwa uye kugadziriswa kwekufamba kwenguva nekushandiswa kushandiswa kweOtezla.
Pane Mhinduro Dzakasiyana Here kana Manyevero uye Kuchengetedzwa Kunobatana naOtezla?
Otezla inopesana nevarwere vane hypersensitivity vanozivikanwa kuti apremilast. Nezvokunyeverwa nekuchengeteka, Otezla inobatanidza nehuwandu hwekuwedzera kwekuora mwoyo. Kurema kwehutachiona kwakatarwawo panguva yekuongororwa kwemakiriniki sechiitiko chinotambudza. Varwere vanofanira kutarisa kusina kutsanangurwa uye kuchipatara zvakakosha kurasika.
Uyewo, kunogona kuve nekukwanisa kudyidzana kwemishonga pakati peOtezla uye cytochrome P450 enzyme inducers, yakadai sa rifampin, phenobarbital, carbamazepine, uye phenytoin iyo inogona kuderedza kubudirira kweOtezla. Kubatanidzwa hakubvumirwi.
Dzidzo dzakachengetedzwa zvakanaka naOtezla hazvina kuitwa mumadzimai ane pamuviri. Otezla inofanira kushandiswa panguva yekuzvitakura chete apo zvingave zvichibatsira zvinowedzera kukanganisa kunogona kuitika kumucheche. Izvo hazvizivikanwi kana Otezla kana metabolites eOtezla aripo mumukaka wemunhu, saka mukoti anofanira kunge akachenjera. Sezvo chikamu chekubvumirwa kwaDFA, kuchava nehurumende yevakadzi vane pamuviri uye vari kurapwa naOtezla.
Otezla Akaita Sei Muchipatara Miedzo?
Kuchengetedzwa nekubudirira kweOtezla kwakaongororwa mumatambudziko matatu emakiriniki anosanganisira 1,493 varwere vane active psoriatic arthritis.
Mune miedzo, anonzi PALACE-1, PALACE-2, uye PALACE-3, vatori vechikamu vanoverenga vaisanganisira placebo, Otezla 20 mg. kana 30 mg. kaviri zuva nezuva. Varwere vakabvumirwa kuramba vari neDMARD, chirwere chakanyanya corticosteroids, kana NSAID panguva yekutongwa. Mhedziso yekupedzisira yaiva ACR20 nevhiki 16. Otezla pamwe neDMARD yakaenzaniswa ne placebo pamwe neDMARD yaibatanidza nekuvandudzwa kukuru kwezviratidzo uye zviratidzo zveporiori arthritis. Paivawo nehumwe hukuru hwekuvandudza mune zvekushanda pamwe naOtezla (30 mg kaviri pazuva) kupfuura placebo.
Chii Chinotarisirwa naOtezla?
Uyu mutengesi wezvinodhaka, Celgene, akaisa mutengo wakazara we $ 22 500 pamakore weOtezla.
Sources:
Otezla (apremilast). Kunyora Mashoko. March 2014.
http://media.celgene.com/content/uploads/otezla-pi.pdf
Kuvandudza 2 - US FDA Inobvumira Celgene Drug yePororiatic Arthritis. Bill Berkrot. Reuters. March 21, 2014.
http://www.reuters.com/article/2014/03/21/celgene-fda-idUSL2N0MI1ED20140321
Otezla Yakagamuchirwa na FDA yePaque Psoriasis. BusinessWire. September 23, 2014.
http://www.businesswire.com/news/home/20140923006559/en/Oral-OTEZLA%C2%AE-apremilast-Approved-US-Food-Drug%23.VCHKX_ldV8E#.VCIn1Bb4Kr8