Minocycline yeRheumatoid Arthritis: Inoshanda here?

Zvemukati

• Nezve off-label kushandisa zvinodhaka
• Ko kutsvagurudza kunotii?
• Yekutanga nhoroondo yekutsvaga
• Pfungwa dzezvidzidzo ne minocycline
• Ko minocycline inoshanda sei kurapa RA?
• Ndiani angabatsirwe neminocycline yeRA?
• Chii chinonzi protocol?
• Ndeipi mhedzisiro?
• Kutora

Mhedziso

Minocycline inorwisa mabhakitiriya mumhuri yetetracycline. Yakave yakashandiswa kune zvinopfuura kurwisa huwandu hwakawanda hwehutachiona.

, vaongorori varatidzira ayo anopesana nekuzvimba, immune-modulating, uye neuroprotective zvivakwa.

Kubva iyo, mamwe ma rheumatologists akabudirira kushandisa tetracyclines ye rheumatoid arthritis (RA). Izvi zvinosanganisira minocycline. Sezvo makirasi matsva emishonga akave kuwanikwa, minocycline kushandiswa kwakaramba. Panguva imwecheteyo, yakaratidza kuti minocycline yaive inobatsira RA.

Minocycline haina kunyatsotenderwa neU.S.Food uye Drug Administration (FDA) yekushandisa neRA. Izvo zvinowanzo nongedzwa "off-label."

Kunyangwe zvayakanakira mhedzisiro mumiyedzo, minocycline kazhinji haina kushandiswa kurapa RA nhasi.

Nezve off-label kushandisa zvinodhaka

Kushandisa-kurebesa kushandisa zvinodhaka zvinoreva kuti mushonga unobvumidzwa neDFA nechinangwa chimwe unoshandiswa nechinangwa chakasiyana chisina kubvumidzwa. Nekudaro, chiremba achiri kugona kushandisa mushonga wechinangwa icho. Izvi zvinodaro nekuti iyo FDA inodzora kuyedzwa uye kubvumidzwa kwemishonga, asi kwete mashandisiro anoita vanachiremba mishonga yekurapa varwere vavo.Saka chiremba wako anokwanisa kukunyorera mushonga asi ivo vanofunga zvakanakira iwe. Dzidza zvakawanda nezve off-label tsamba yekushandisa zvinodhaka.

Ko kutsvagurudza kunotii?

kubvira kuma1930 ekupedzisira kuti mabhakitiriya anobatanidzwa mukukonzera RA.

Kliniki uye inodzorwa yekutsvagisa zvidzidzo zve minocycline kushandiswa kweRA kazhinji vanopedzisa kuti minocycline inobatsira uye yakachengeteka kune vanhu vane RA.

Mamwe maantibayoti anosanganisira sulfa compounds, mamwe tetracyclines, uye rifampicin. Asi minocycline yave iri nyaya yezvakawanda zvakapofumadza-mapofu uye kiriniki miedzo nekuda kwenzvimbo dzayo yakafara.

Yekutanga nhoroondo yekutsvaga

Muna 1939, American rheumatologist Thomas McPherson-Brown nevamwe vaaishanda navo vakasarudzira hutachiona-hwakaita sehutachiona kubva kuRA tishu. Vakaitumidza kuti mycoplasma.

Gare gare McPherson-Brown akatanga kuyedza kurapwa kweRA nemishonga inorwisa mabhakitiriya. Vamwe vanhu pakutanga vakawedzera kuipa. McPherson-Brown akataura izvi neiyo Herxheimer, kana "kufa-kure," mhedzisiro: Kana mabhakitiriya akarwiswa, anoburitsa chepfu inotanga kukonzera zviratidzo zvehosha kubuda. Izvi zvinoratidza kuti kurapwa kuri kushanda.

Munguva yakareba, varwere vakapora. Vazhinji vakawana kuregererwa mushure mekutora iyo inorwisa mabhakitiriya kwemakore anosvika matatu.

Pfungwa dzezvidzidzo ne minocycline

Chidzidzo chegumi chakafananidza tetracycline mishonga inorwisa mabhakitiriya kuchipatara kurapwa kana placebo ine RA. Chidzidzo ichi chakagumisa kuti tetracycline (uye kunyanya minocycline) kurapwa kwaive kwakabatana nekuvandudza kwaive kwakakosha kuchipatara.

Chidzidzo che1994 chakadzorwa che minocycline nevatori vechikamu makumi matanhatu neshanu vakataura kuti minocycline yaive inobatsira kune avo vane RA inoshanda. Ruzhinji rwevanhu vari muchidzidzo ichi vaive vafambira mberi RA.

A wevanhu 219 vane RA vakafananidza kurapwa ne minocycline kune placebo. Vatsvakurudzi vakagumisa kuti minocycline yaishanda uye yakachengeteka mune zvinyoro kusvika pakuenzanisa zviitiko zveRA.

Chidzidzo che2001 chevanhu makumi matanhatu vane RA vakafananidza kurapwa ne minocycline kune hydroxychloroquine. Hydroxychloroquine chirwere-chinogadzirisa antirheumatic drug (DMARD) inowanzo shandiswa kurapa RA. Vatsvaguriri vakati minocycline yainyanya kushanda kupfuura maDMARD eRA yekutanga seropositive.

Makore mana ekutevera-akatarisa varwere makumi mana nevapfumbamwe muchidzidzo cheapofu-chechipiri chakaenzanisa kurapwa ne minocycline kune placebo. Izvo zvakare zvakurudzira minocycline yaive inoshanda kurapwa kweRA. Vanhu vaibatwa ne minocycline vaine kuregererwa kushoma uye vaida kurapwa kwetsika kushoma. Izvi zvaive zvakadaro kunyangwe iyo kosi ye minocycline yaingova matatu kusvika kumwedzi mitanhatu.

Izvo zvakakosha kuti uzive kuti mazhinji eaya mafundo aisanganisira iko kupfupisa-kushandisa minocycline. McPherson-Brown akasimbisa kuti nzira yekurapa kusvika kuregererwa kana kugadzirisa kwakanyanya kunogona kutora kusvika kumakore matatu.

Ko minocycline inoshanda sei kurapa RA?

Iyo chaiyo michina ye minocycline seRA kurapwa haina kunyatsonzwisiswa. Pamusoro peantimicrobial chiito, minocycline ine anti-kupisa zvinhu. Kunyanya, minocycline ku:

• inokanganisa nitric oxide synthase, iyo inosanganisirwa mukudzikisira kwe collagen
• kunatsiridza interleukin-10, iyo inotitadzisa pro-kuzvimba cytokine mu synovial tishu (inobatanidza matishu akakomberedza majoini)
• kudzvinyirira B uye T masero mashandiro ezvirwere zvemuviri

Minocycline inogona kunge iine. Izvi zvinoreva kuti inogona kusimudzira kurapwa kweRA ikasanganiswa neasina-steroidal anti-anogumbura zvinodhaka kana imwe mishonga.

Ndiani angabatsirwe neminocycline yeRA?

Zvinokurudzirwa mune kuti vakanyanya kukwikwidza ndevaya vari muchikamu chekutanga cheRA. Asi kumwe kutsvagurudza kunoratidza kuti vanhu vane raiti yepamusoro RA vanogona zvakare kubatsirwa.

Chii chinonzi protocol?

Iyo yakajairwa zvinodhaka protocol mukutsvagisa zvidzidzo ndeye 100 milligrams (mg) kaviri pazuva.

Asi munhu wega wega akasiyana, uye iyo minocycline protocol inogona kusiyana. Vamwe vanhu vangangoda kutanga nemushonga wakaderera uye vanoshanda kusvika ku100 mg kana kupfuura kaviri pazuva. Vamwe vangangoda kutevera yakasundirwa sisitimu, vachitora minocycline mazuva matatu pasvondo kana kuisiyanisa nemamwe madhiragi.

Kufanana nemishonga inorwisa mabhakitiriya yechirwere cheLyme, hapana imwe-saizi-inokodzera-nzira yese. Zvakare, zvinogona kutora kusvika kumakore matatu kuti uone mhedzisiro mune mamwe maRA kesi.

Ndeipi mhedzisiro?

Minocycline inowanzo shandiswa zvakanaka. Izvo zvinogona kuitika mhedzisiro zvine mwero uye zvakafanana neizvo zvemamwe maantibhakitiriya. Zvinosanganisira:

• matambudziko emudumbu
• dzungu
• kutemwa nemusoro
• kuputika kweganda
• kuwedzera kunzwisisika kune zuva
• kusangana nekutsi kwemukadzi mbiriso chirwere
• hyperpigmentation

Kutora

Minocycline, kunyanya yakashandiswa kwenguva yakareba, yakaratidzwa kuvandudza RA zviratidzo uye kubatsira kuisa vanhu mukuregererwa. Haisi kushandiswa zvakanyanya nhasi, kunyangwe yakaverengerwa rekodhi.

Nhaurwa dzinowanzo kupihwa dzinopesana ne minocycline kushandiswa kweRA ndeiyi:

• Iko hakuna zvakakwana zvidzidzo.
• Mishonga inorwisa mabhakitiriya ine mhedzisiro.
• Mimwe mishonga inoshanda zvirinani.

Vamwe vaongorori uye maRheumatologists havabvumirani nenharo idzi uye vanonongedzera kumhedzisiro yezvidzidzo zviripo.

Zvakakosha kuve nechekuita pakuronga kurapwa kwako uye kutsvaga dzimwe nzira. Kurukura nachiremba wako izvo zvingave zvakanakira iwe chaiwo mamiriro.

Kana iwe uchida kuyedza minocycline uye chiremba wako achikuodza moyo, bvunza kuti nei. Ratidza nhoroondo yakanyorwa yekushandisa minocycline. Taura nachiremba nezve iyo mhedzisiro yekutora steroid kwenguva yakareba uchienzaniswa neyakaenzana mhedzisiro mhedzisiro yeminocycline. Unogona kuda kutsvaga nzvimbo yekutsvagisa yakashanda ne minocycline neRA.