Nyowani Rheumatoid Arthritis Kurapa uye Zvidzidzo: Iyo Nyowani Ongororo

Zvemukati

• JAK inhibitors inopa zororo
• BTK inhibitor mukuvandudza
• Neurostimulation inoratidza vimbiso
• Omega-3 fatty acids inogona kubatsira
• RA mishonga inosanganisirwa nemoyo hutano mabhenefiti
• Kutora

Rheumatoid arthritis (RA) chirwere chisingaperi chinokonzera kuzvimba kwemajoini, kuomarara, uye kurwadziwa. Iko hakuna kuzivikanwa kurapa kweRA - asi kune mishonga iripo yekubatsira kubvisa zviratidzo, kudzikisira kubatana kwekubatana, nekusimudzira hutano hwakanaka hwakazara.

Sezvo masayendisiti achiramba achivandudza nekuvandudza marapirwo eRA, chiremba wako anogona kukurudzira shanduko kuchirongwa chako chekurapa.

Verenga pamusoro kuti udzidze nezve zvimwe zvekutsvaga kutsva uye nzira nyowani dzekurapa dzeichi chiitiko.

JAK inhibitors inopa zororo

Vanhu vazhinji vane RA vanoshandisa mhando yechirwere-kugadzirisa antirheumatic drug (DMARD) inozivikanwa se methotrexate. Asi mune dzimwe nguva, kurapwa ne methotrexate chete hakuna kukwana kudzora zviratidzo.

Kana iwe wanga uchitora methotrexate uye iwe uchiri kuona zvine mwero kusvika kune zvakakomba zviratidzo zveRA, chiremba wako anogona kukurudzira kukurudzira kuwedzera janus kinase (JAK) inhibitor kuchirongwa chako chekurapa. JAK inhibitors anobatsira kumisa makemikari maitiro anokonzera kuzvimba mumuviri wako. Methotrexate inoita izvi, futi, asi neimwe nzira. Kune vamwe vanhu, JAK inhibitors inoshanda zvinobudirira.

Parizvino, Chikafu neDrug Administration (FDA) yakabvumidza matatu marudzi eJAK inhibitors kurapa RA:

• tofacitinib (Xeljanz), yakagamuchirwa muna2012
• baricitinib (Olumiant), inogamuchirwa muna 2018
• upadacitinib (Rinvoq), inogamuchirwa mu2019

Vatsvagiri vari kuenderera mberi nekudzidza iyi mishonga kuti vadzidze kuti vanoenzanisa sei kune mumwe nemumwe, uye nedzimwe nzira dzekurapa. Semuenzaniso, masayendisiti munguva pfupi yapfuura akawana kuti mubatanidzwa wemethotrexate uye upadacitinib wainyanya kushanda kupfuura methotrexate uye adalimumab yekudzora marwadzo nekuvandudza mashandiro muvanhu vane RA. Vanopfuura vanhu chiuru nemazana matanhatu vane RA vakapinda muchidzidzo ichi.

Zvirwere zvemakiriniki zviri kuenderera mberi kugadzira JAK inhibitors nyowani, kusanganisira mushonga wekuyedza unozivikanwa se filgotinib. Muchikamu chechangobva kuitika chechitatu chemakiriniki ekuyedzwa, filgotinib yakawanikwa ichishanda kupfuura nzvimbo yekurapa RA muvanhu vakamboedza imwe kana kupfuura maDMARD. Kumwe kutsvagurudza kunodiwa kuti uongorore kuchengetedza kwenguva refu uye kushanda kwechirwere ichi chekuyedza.

Kuti udzidze zvakawanda nezve zvingabatsire uye njodzi dzekutora JAK inhibitor, taura nachiremba wako. Vanogona kukubatsira iwe kudzidza kana mhando iyi yemishonga ingave sarudzo yakanaka kwauri.

BTK inhibitor mukuvandudza

Bruton's tyrosine kinase (BTK) enzyme inoita basa mukukudziridza kuzvimba. Kuvhara chiito cheBTK, vaongorori vanga vachigadzira uye kuyedza BTK inhibitor inozivikanwa se fenebrutinib.

Zvidzidzo zvekutanga zvinoratidza kuti fenebrutinib inogona kupa imwe nzira yekurapa yeRA. Boka repasi rese revatsvakurudzi munguva pfupi yapfuura rakapedza chikamu chechipiri chemakiriniki kuyedzwa kuti vadzidze nezvekuchengetedza uye kushanda kwefenebrutinib yekurapa mamiriro aya. Vakaona kuti fenebrutinib yaigamuchirwa yakachengeteka uye zvine mwero inoshanda.

Chidzidzo chacho chakawana kuti kana ichibatanidzwa ne methotrexate, fenebrutinib yainyanya kushanda kupfuura placebo yekurapa zviratidzo zveRA. Fenebrutinib yaive nemitengo yakafanana yekubudirira seadalimumab.

Kumwe kutsvagurudza kunodiwa kuti udzidze kuchengetedzeka uye kushanda kwefenebrutinib.

Neurostimulation inoratidza vimbiso

Vamwe vanhu vanoedza akawanda mishonga yekurapa RA, pasina kubudirira.

Seimwe nzira yemishonga, vatsvagiri vari kudzidza zvingabatsire uye njodzi dzenzara yekusimudzira kurapa RA. Mune ino nzira yekurapa, magetsi emagetsi anoshandiswa kukurudzira iyo vagus nerve. Iyi nerve inobatsira kudzora kuzvimba mumuviri wako.

Masayendisiti munguva pfupi yapfuura akaitisa yekutanga mu-munhu mutyairi wenyanzvi kudzidza vagus nerve kukurudzira kwekurapa RA. Vakaisa diki neurostimulator kana sham mudziyo mune vanhu gumi nevana vane RA. Vatanhatu veavo vanhu vaibatwa ne vagus nerve kukurudzira kamwe pazuva pazuva kwevhiki gumi nembiri.

Pakati pevatori vechikamu vakagashira zuva nezuva vagus nerve kukurudzira, vana kubva pavatanhatu vatori vechikamu vakaona kuvandudzwa kwezviratidzo zveRA. Vashoma vatori vechikamu vakaona zviitiko zvakashata panguva yekurapwa, asi hapana chezviitiko zvakataurwa chaive chakakomba kana chechigarire.

Omega-3 fatty acids inogona kubatsira

Kunze kwekutora yako yakatemwa mishonga, zvidzidzo zvinoratidza kuti kuwedzera iyo omega-3 yekuwedzera kune yako yezuva nezuva maitiro anogona kubatsira kudzikisira RA zviratidzo.

Omega-3 fatty acid yekushandisa yakabatanidzwa nekuderedza kuzvimba mumuviri. Vanoferefeta kubva kuYunivhesiti yeHouston pavakaongorora tsvagiridzo ye omega-3 yekuwedzera, vakawana makumi maviri emakiriniki miedzo yakanangana neRA kunyanya. Mune gumi nematanhatu kubva pamiedzo makumi maviri, omega-3 yekuwedzera yainge yakabatana nekuvandudzwa kukuru kwezviratidzo zveRA.

Ongororo ichangoburwa yekucherechedza yawanawo chinongedzo pakati pe omega-3 yekuwedzera uye yakaderedza chiitiko chehosha mune vanhu vane RA. Pa 2019 ACR / ARP Musangano Wegore Negore, vatsvagiri vakataura mhedzisiro yehurefu hwekurejista kudzidza kwevanhu 1,557 vane RA. Vatori vechikamu vanotaura kuti vatora omega-3 zvinowedzerwa vaive nezvirwere zvakaderera zviitiko, zvisungo zvishoma zvekuzvimba, uye majoini anorwadza paavhareji pane avo vasina kutora omega-3 zvinowedzera.

RA mishonga inosanganisirwa nemoyo hutano mabhenefiti

Mimwe RA mishonga inogona kunge iine mabhenefiti emoyo wako, pamwe nemajoini ako. Zvinoenderana nezvidzidzo zviviri zvitsva zvakaunzwa kumusangano wegore negore we2019 ACR / ARP, mishonga iyoyo inosanganisira methotrexate uye hydroxychloroquine.

Mune kumwe kuongorora, vaongorori vakatevera veterans 2,168 neRA kubva 2005 kusvika 2015. Vakaona kuti vatori vechikamu vakagamuchira kurapwa ne methotrexate vaive nemikana mishoma yekusangana nezviitiko zvemoyo, sekurwadziwa nemoyo kana sitiroko. Vatori vechikamu vakagashira methotrexate vaive zvakare nemukana wekuzoiswa muchipatara nekuda kwekutadza kwemoyo.

Mune kumwe kuongorora, vatsvagiri veCanada vakaongorora zvinyorwa zverejista zvakaunganidzwa kubva kumapoka matatu: vanhu vane RA, vanhu vane systemic lupus erythematosus (SLE), uye masimba ane hutano asina kana mamiriro. Vanhu vane RA kana SLE vaibatwa nehydroxychloroquine vaive nenjodzi yakadzikira yezviitiko zvemoyo, zvakadai sekurwadziwa nemoyo kana sitiroko.

Kutora

Kubudirira kwesainzi yezvokurapa kunogona zvakare kubatsira vaongorori kugadzirisa marapirwo aripo nekuvandudza nzira nyowani dzekurapa dzekutarisira RA.

Kuti udzidze zvakawanda nezvesarudzo dzazvino dzekurapa RA, taura nachiremba wako. Vanogona kukubatsira kuti unzwisise zvingabatsire uye njodzi dzekugadzirisa chirongwa chako chekurapa. Ivo vanogona zvakare kukurudzira mararamiro ehupenyu, senge kusasvuta kana kuputa, kuti ikubatsire kunakidzwa neakanakisa hutano uye mhando yehupenyu neichi chiitiko.