Unoita Sei Oral Kurapwa kweMS Kushanda?

Zvemukati

• Basa reB masero uye T maseru
• Cladribine (Mavenclad)
• Dimethyl fumarate (Tecfidera)
• Diroximel fumarate (Kuwanda)
• Fingolimod (Gilenya)
• Siponimod (Mayzent)
• Teriflunomide (Aubagio)
• Zvimwe zvinodhaka-zvinoshandura zvinodhaka
• Ingangoita njodzi yemhedzisiro kubva kuDMTs
• Kugadzirisa njodzi yemhedzisiro
• Kutora
• Izvi ndizvo zvazvinonzwa sekurarama neMS

Multiple sclerosis (MS) chirwere che autoimmune umo immune system yako inorwisa iyo inodzivirira inodzivirira yakakomberedza tsinga mukati medu wepakati system (CNS). Iyo CNS inosanganisira yako uropi uye musana tambo.

Zvirwere-zvinoshandura marapirwo (DMTs) ndiwo marapirwo akakurudzirwa kubatsira kunonoka kukura kweMS. DMTs inogona kubatsira kunonoka kuremara uye kudzikamisa kuwanda kwemafire kune vanhu vane mamiriro.

Chikafu neDrug Administration (FDA) yakabvumidza maDMTs akawanda kuti arape mafomu ekudzoka eMS, kusanganisira maDMTs matanhatu anotorwa nemuromo semapilisi kana mapiritsi.

Verenga pamusoro kuti udzidze zvakawanda nezve zvemuromo DMTs uye nemabatiro avanoshanda.

Basa reB masero uye T maseru

Kuti unzwisise kuti muromo weDMTS unobatsira sei kubata MS, unofanirwa kuziva nezve iro basa remamwe maseru ekudzivirira muMS.

Mhando zhinji dzemaseru ekudzivirira uye mamorekuru anobatanidzwa mune isina kujairika immune mhinduro iyo inokonzeresa kuzvimba nekukuvara muMS.

Izvi zvinosanganisira T masero uye B maseru, marudzi maviri esero jena reropa rinozivikanwa sema lymphocyte. Izvo zvinogadzirwa mumuviri wako lymphatic system.

Kana T maseru achifamba kubva kune yako lymphatic system kuenda muropa rako, vanogona kuenda kuCNS yako.

Dzimwe mhando dzemasero eT dzinoburitsa mapuroteni anozivikanwa se cytokines, ayo anokonzeresa kuzvimba. Mune vanhu vane MS, pro-inflammatory cytokines inokanganisa myelin uye maseru etsinga.

B maseru zvakare anogadzira pro-anogumbura cytokines, ayo anogona kubatsira kutyaira zviitiko zvehosha-zvichikonzera masero eT muMS. B masero anogadzirawo maantibhakitiriya, anogona kuita basa muMMS.

MaDMTs mazhinji anoshanda nekudzikisira kuisirwa, kupona, kana kufamba kwemaT seli, B maseru, kana ese ari maviri. Izvi zvinobatsira kudzora kuzvimba uye kukuvara muCNS. Mamwe maDMTs anodzivirira maseru etsinga kubva mukukuvara nedzimwe nzira.

Cladribine (Mavenclad)

Iyo FDA yakabvumidza kushandiswa kwecladribine (Mavenclad) kurapa kudzokazve mafomu eMS muvakuru. Parizvino, hapana zvidzidzo zvakapedzwa pakushandiswa kweMavenclad muvana.

Kana mumwe munhu achitora mushonga uyu, unopinda mumasero eT nemaB mumasero avo uye zvinokanganisa kugona kwemasero kugadzira uye kugadzirisa DNA. Izvi zvinokonzeresa kuti maseru afe, zvichideredza huwandu hweT masero nemaB maseru mune avo immune system.

Kana iwe ukatambira kurapwa neMavenclad, iwe unotora makosi maviri emushonga pamusoro pemakore maviri. Kosi yega yega inosanganisira 2 mavhiki ekurapa, akapatsanurwa nemwedzi mumwe.

Pakati pevhiki yega yekurapa, chiremba wako anokuraira kuti utore imwe kana maviri ezvinodhaka zvezuva nezuva zvemushonga kwemazuva mana kana mashanu.

Dimethyl fumarate (Tecfidera)

Iyo FDA yakabvumidza dimethyl fumarate (Tecfidera) yekurapa mafomu ekudzokazve eMS muvakuru.

Iyo FDA haisati yatendera Tecfidera yekurapa MS muvana. Zvisinei, vanachiremba vanogona kupa mushonga uyu kuvana mune tsika inozivikanwa se "off-label" kushandiswa.

Kunyangwe hazvo kutsvagurudza kuchidikanwa, zvidzidzo kusvika zvino zvinoratidza kuti uyu mushonga wakachengeteka uye unoshanda pakurapa MS muvana.

Nyanzvi hadzinyatso kuziva kuti Tecfidera inoshanda sei. Nekudaro, vaongorori vakawana uyu mushonga ungaderedze kuwanda kwemamwe marudzi emaT seli nemaB maseru, pamwe nepro-inflammatory cytokines.

Tecfidera zvakare inoita kunge inogonesa protein inozivikanwa seyukireya factor erythroid 2-inoenderana chinhu (NRF2). Izvi zvinokonzeresa mhinduro dzemaseru dzinobatsira kuchengetedza maseru etsinga kubva mukushushikana kweiyo oxidative.

Kana iwe wakarairwa Tecfidera, chiremba wako anokuraira iwe kuti utore maviri ma120-milligram (mg) doses pazuva kwemazuva manomwe ekutanga ekurapwa. Mushure mevhiki yekutanga, ivo vanokuudza kuti utore ma240-mg doses pazuva zuva rega.

Diroximel fumarate (Kuwanda)

Iyo FDA yakabvumidza diroximel fumarate (Vumerity) kurapa kudzokazve mafomu eSMS muvakuru. Nyanzvi hadzisati dzaziva kuti uyu mushonga wakachengeteka kana unoshanda muvana.

Kuwanda chikamu chekirasi imwechete yemishonga seTecfidera. SaTecfidera, inofungidzirwa kuti inogonesa protein NRF2. Izvi zvinogadzirisa mhinduro dzemaseru dzinobatsira kudzivirira kukuvara kwemaseru etsinga.

Kana chirongwa chako chekurapa chinosanganisira Vumerity, chiremba wako anokuraira kuti utore 231 mg yemushonga kaviri pazuva pazuva kwemazuva manomwe ekutanga. Kubva panguva iyoyo zvichienda mberi, iwe unofanirwa kutora 462 mg yemushonga kaviri pazuva.

Fingolimod (Gilenya)

Iyo FDA yakabvumidza fingolimod (Gilenya) yekurapa mafomu ekudzokazve eMS muvakuru pamwe nevana vane makore gumi kana gumi.

Iyo FDA haisati yatendera iyi mishonga yekurapa vana vadiki, asi vanachiremba vanogona kuiraira kure-kunyorera kuvana vari pasi pezera regumi.

Mushonga uyu unovhara mhando yekuratidzira mamorekuru anozivikanwa se sphingosine 1-phosphate (S1P) kubva pakusunga kusvika kumasero eT nemaB masero. Nekudaro, izvi zvinodzivirira iwo maseru kubva pakupinda muropa uye kuenda kuCNS.

Kana iwo maseru akamiswa kubva kuenda kuCNS, haakwanise kukonzera kuzvimba nekukuvadza ipapo.

Gilenya inotorwa kamwe pazuva. Mune vanhu vane huremu hunopfuura mapaundi makumi masere nemasere (makirogiramu makumi mana), iro rinokurudzirwa zuva rega rega ndi 0.5 mg. Mune avo vanoyera zvishoma pane izvo, iyo inorayirwa zuva nezuva muyero ndeye 0.25 mg.

Kana iwe ukatanga kurapwa nemushonga uyu uye wobva warega kuushandisa, unogona kusangana nemoto unopisa.

Vamwe vanhu vane MS vakagadzira kuwedzera kwakanyanya mukuremara uye maronda matsva ehuropi mushure mekumira kwavo kutora mushonga uyu.

Siponimod (Mayzent)

Iyo FDA yakabvumidza siponimod (Mayzent) yekurapa kudzokazve mafomu eMS muvakuru. Parizvino, vaongorori havasati vapedza chero zvidzidzo nezvekushandisa kwemushonga uyu muvana.

Mayzent ari mukirasi imwechete yemishonga seGilenya. SaGilenya, inovhara S1P kubva pakusunga kusvika kumasero eT nemaB maseru. Izvi zvinomisa maseru ekudzivirira aya kuenda kuuropi uye musana, kwaanogona kukanganisa.

Mayzent inotorwa kamwe chete pazuva. Kuti uone chiyero chako chezuva nezuva, chiremba wako achatanga nekukuongorora iwe kuti uwane chiratidzo chinokwanisa kubatsira kufanotaura mhinduro yako kumushonga uyu.

Iyo yako genetiki mhedzisiro mhedzisiro inoratidza kuti uyu mushonga ungashande zvakanaka kwauri, chiremba wako anokuraira diki diki yekutanga. Ivo vanozowedzera zvishoma nezvishoma yako yakatemwa dosi mune maitiro anozivikanwa se titration. Chinangwa ndechekugadzirisa zvingangoita mabhenefiti uku uchidzikisira mhedzisiro.

Kana iwe ukatora mushonga uyu uye wobva warega kuushandisa, mamiriro ako anogona kuwedzera kuipa.

Teriflunomide (Aubagio)

Iyo FDA yakabvumidza kushandiswa kwe teriflunomide (Aubagio) yekurapa mafomu ekudzokazve eMS muvakuru. Hapana zvidzidzo zvakaburitswa parizvino nezvekushandisa kwechirwere ichi muvana.

Aubagio inovhara enzyme inozivikanwa se dihydroorotate dehydrogenase (DHODH). Iyi enzyme inosanganisirwa mukugadzirwa kwepyrimidine, chivakwa cheDNA chinodikanwa pakuumbwa kweDNA mumasero eT nemaB masero.

Kana iyi enzyme isingakwanise kuwana pyrimidine yakakwana kuti igadzire DNA, inotadzisa kuumbwa kwemasero matsva eT nemaB masero.

Kana iwe uchinge wagamuchira kurapwa neAubagio, chiremba wako anogona kunyorera 7- kana 14-mg yezuva nezuva dosi.

Zvimwe zvinodhaka-zvinoshandura zvinodhaka

Pamusoro peiyi mishonga yemumuromo, iyo FDA yakabvumidza maDMTs akati wandei akaiswa jekiseni pasi peganda kana kupihwa kuburikidza nekuiswa infravenous.

Zvinosanganisira:

• alemtuzumab (Lemtrada)
• glatiramer acetate (Copaxone, Glatect)
• interferon beta-1 (Avonex)
• interferon beta-1a (Rebif)
• interferon beta-1b (Betaseron, Extavia)
• mitoxantrone (Novantrone)
• natalizumab (Tysabri)
• ocrelizumab (Ocrevus)
• peginterferon beta-1a (Kunaka)

Taura nachiremba wako kuti udzidze zvakawanda nezve iyi mishonga.

Ingangoita njodzi yemhedzisiro kubva kuDMTs

Kurapa neDMTs kunogona kukonzera mhedzisiro, iyo mune zvimwe zviitiko yakakomba.

Iyo inogona mhedzisiro mhedzisiro yekurapa inosiyana zvichienderana nerumwe rudzi rweDMT yaunotora.

Mimwe mhedzisiro mhedzisiro inosanganisira:

• musoro
• kusvotwa
• kurutsa
• manyoka
• kuputika kweganda
• kurasikirwa nevhudzi
• kunonoka kurova kwemoyo
• kumeso kumeso
• kusagadzikana mudumbu

DMTs inosanganisirwa nekuwedzera njodzi yehutachiona, senge:

• furuwenza
• bronchitis
• tibhii
• shingles
• humwe hutachiona hutachiona
• inofambira mberi multifocal leukoencephalopathy, isingawanzo mhando yehutachiona hutachiona

Iyo yakawedzera njodzi yekutapukirwa ndeyekuti mishonga iyi inoshandura immune system yako uye inogona kudzikisa huwandu hwezvirwere-kurwisa chena masero eropa mumuviri wako.

DMTs inogona kukonzeresa mamwe akanyanya mhedzisiro, sekukuvara kwechiropa uye zvakakomba zvemaitiro ekurwisa. Mamwe maDMTs anogona kukonzera kukanganiswa kweropa rako. Zvimwe zvinogona kukonzera kurova kwemoyo wako kunonoka.

Ramba uchifunga kuti chiremba wako achakurudzira DMT kana ivo vachitenda kuti zvinogona kubatsira zvinopfuura njodzi.

Kugara neMS iyo isinganyatso kutarisirwa inotakurawo njodzi dzakakomba. Taura nachiremba wako kuti udzidze zvakawanda nezve zvingangoitika mhedzisiro uye mabhenefiti eakasiyana maDMTs.

DMTs hazviwanzo kunzi dzakachengeteka kune vanhu vane nhumbu kana kuyamwisa.

Kugadzirisa njodzi yemhedzisiro

Usati watanga kurapwa neDMT, chiremba wako anofanira kukutarisa kuti utapukire hutachiona, kukuvara kwechiropa, uye mamwe matambudziko ehutano anogona kusimudza njodzi dzekutora mushonga.

Chiremba wako anogonawo kukukurudzira kuti ugamuchire majekiseni usati watanga kurapwa neDMT. Ungangoda kumirira vhiki dzinoverengeka mushure mekugamuchira majekiseni usati watanga kutora mushonga.

Paunenge uchigamuchira kurapwa neDMT, chiremba wako anogona kukuraira kuti udzivise mimwe mishonga, zvinowedzera zvinovaka muviri, kana zvimwe zvigadzirwa. Vabvunze kana paine chero mishonga kana zvimwe zvigadzirwa zvinogona kuwirirana kana kupindira neDMT.

Chiremba wako anofanirawo kukutarisa iwe nezviratidzo zvemhedzisiro panguva uye mushure mekurapwa neDMT. Semuenzaniso, ivo vangango hodha kuongororwa kweropa nguva nenguva kuti vaongorore kuwanda kwemasero eropa uye ma enzymes echiropa.

Kana iwe uchifunga kuti ungave uri kusangana nemhedzisiro, ita chiremba wako azive ipapo ipapo.

Kutora

Multiple DMTs yakave yakabvumidzwa kurapa MS, kusanganisira zvitanhatu marudzi ekurapa kwemuromo.

Mimwe yemishonga iyi inogona kuve yakachengeteka kana kukodzera zvirinani kune vamwe vanhu kupfuura vamwe.

Usati watanga kutora DMT, bvunza chiremba wako nezve zvingabatsire uye njodzi dzekuishandisa. Vanogona kukubatsira kuti unzwisise kuti marapirwo akasiyana angakanganisa sei muviri wako uye maonero erefu-refu neMS.

Izvi ndizvo zvazvinonzwa sekurarama neMS