Rituxan Infusion yeRheumatoid Arthritis: Chii Chaunotarisira

Zvemukati

• Mhedziso
• Ndiani mukwikwidzi akanaka wekurapwa uku?
• Ko kutsvagurudza kunotii?
• Rituxan yeRA inoshanda sei?
• Chii chaunotarisira panguva yekuwedzeredzwa
• Ndeipi mhedzisiro?
• Kutora

Mhedziso

Rituxan mushonga webiologic unobvumidzwa neyakagamuchirwa neU.S.Food and Drug Administration (FDA) muna 2006 kurapa rheumatoid arthritis (RA). Zita rayo rinowanzoitwa rituximab.

Vanhu vane RA vasina kupindura kune mamwe marudzi ekurapa vanogona kushandisa Rituxan pamwe chete nemushonga methotrexate.

Rituxan imvura isina ruvara inopihwa nekumisirwa. Iyo antibody inogadzirwa nemajini inonongedza masero eB anosanganisira RA kuzvimba. Iyo FDA yakabvumidzawo Rituxan kune isiri-Hodgkin's lymphoma, chisingaperi lymphocytic leukemia, uye granulomatosis ine polyangiitis.

Zvese rituximab uye methotrexate, immune-system suppressor, yakatanga kugadzirwa uye kushandiswa seanticancer zvinodhaka. Rituxan inogadzirwa naGenentech. KuEurope, inotengeswa seMabThera.

Ndiani mukwikwidzi akanaka wekurapwa uku?

Iyo FDA yakabvumidza kurapwa neRituxan uye methotrexate:

• kana iwe uine zvine mwero kune zvakanyanya RA
• kana usati wapindura zvakanaka kurapa nema blocking agents e tumor necrosis factor (TNF)

Iyo FDA inoraira kuti Rituxan inofanira kushandiswa panguva yekuzvitakura chete kana mukana wekubatsira kuna amai uchipfuura chero njodzi inogona kuitika kumwana asati aberekwa. Kuchengetedzwa kweRituxan kushandiswa nevana kana vanaamai vanoyamwisa hakusati kwasimbiswa.

Iyo FDA inokurudzira kupokana nekushandiswa kweRituxan kune vanhu vane RA vasina kurapwa pamwe chete kana akawanda anodzivirira vamiririri veTNF.

Rituxan haina kukurudzirwa kune vanhu vane hepatitis B kana kutakura hutachiona, nekuti Rituxan inogona kumutsidzira hepatitis B.

Ko kutsvagurudza kunotii?

Kubudirira kwe rituximab mune yekutsvagisa kudzidza kwaive. Mimwe miedzo yekiriniki yakatevera.

Iyo FDA kubvumidzwa kweRituxan kushandiswa kweRA kwaive kwakavakirwa pazvidzidzo zvitatu zvakapofumadza zvakapfuuridza rituximab uye methotrexate kurapwa ne placebo uye methotrexate.

Imwe yedzidzo dzekutsvagisa yaive makore maviri-akasarudzika kudzidza anonzi REFLEX (Randomized Kuongorora kweKureba-Kwekufamba Kwekuita kweRituximab muRA).Kubudirira kwakayerwa uchishandisa iyo American College yeRheumatology (ACR) kuongorora kwekuvandudza mukubatana nyoro uye kuzvimba.

Vanhu vakagashira rituximab vaive nemaviri infusions, mavhiki maviri akaparadzana. Mushure memasvondo makumi maviri nemana, REFLEX yakawana kuti:

• 51 muzana yevanhu vanorapwa ne rituximab maringe ne 18 muzana inorapwa ne placebo yakaratidza kuvandudzwa kwe ACR20
• 27 muzana yevanhu vanorapwa ne rituximab maringe ne 5 muzana yevanhu vanorapwa ne placebo vakaratidza kuvandudzwa kwe ACR50
• 12 muzana yevanhu vanorapwa ne rituximab maringe ne1 muzana yevanhu vanorapwa ne placebo vakaratidza kuvandudzwa kwe ACR70

Idzo ACR nhamba pano dzinoreva kuvandudzwa kubva kune yekutanga RA zviratidzo.

Vanhu vaibatwa neRituximab vaive nekuvandudzwa kwakakura mune zvimwe zviratidzo senge kuneta, kuremara, uye hupenyu hwehupenyu. X-rays zvakare yakaratidza maitiro kune mashoma mashoma majoini.

Vamwe vanhu vari muchidzidzo vakawana mhedzisiro, asi izvi zvaive zvine hunyoro kusvika pakati nepakati.

kubvira 2006 vakawana mabhenefiti akafanana ekurapwa ne rituximab uye methotrexate.

Rituxan yeRA inoshanda sei?

Iyo michina yekubudirira kwe rituximab pakurapa RA nezvimwe zvirwere. Izvo zvinofungidzirwa kuti rituximab antibodies inotarisa mamorekuru (CD20) pamusoro pemamwe maseru eB anosangana neRA kuzvimba maitiro. Aya maseru B anofungidzirwa kuve anobatanidzwa mukugadzira rheumatoid factor (RF) uye zvimwe zvinhu zvine chekuita nekuzvimba.

Rituximab inoonekwa kune kwechinguva asi kupera kwakazara kwemasero eB muropa uye kupera kwakasarudzika mumongo wemapfupa uye munyama. Asi aya masero B anodzokazve mukati. Izvi zvingangoda kuenderera mberi kweRituximab infusion kurapwa.

Kutsvagurudza kuri kuenderera mberi kuongorora kuti rituximab neB masero anoshanda sei muRA.

Chii chaunotarisira panguva yekuwedzeredzwa

Rituxan inopihwa nedrip kupinda mutsinga (intravenous infusion, kana IV) munzvimbo yezvipatara. Iko kuyerwa kwakapetwa chiuru-milligram (mg) infusions yakaparadzaniswa nevhiki mbiri. Iyo Rituxan infusion haina kurwadza, asi iwe unogona kunge uine alejiki-yerudzi rwekuita kumushonga.

Chiremba wako anoongorora hutano hwako hwese usati wapa kurapwa uye nekukutarisa iwe panguva yekumukirwa.

Hafu yeawa pamberi peRituxan infusion yatanga, iwe unozopihwa infusion ye100 mg ye methylprednisolone kana yakafanana steroid uye pamwe zvakare antihistamine uye acetaminophen (Tylenol). Izvi zvinokurudzirwa kuti ubatsire kudzikisira chero kuitisa kuitika kune iyo infusion.

Kuiswa kwako kwekutanga kunotanga zvishoma nezvishoma pachiyero che50 mg paawa, uye chiremba acharamba achiongorora zviratidzo zvako zvakakosha kuti uve nechokwadi chekuti hauna chaunopindura pakuzadzwa.

Iyo yekutanga infusion maitiro inogona kutora anenge maawa mana nemaminitsi gumi nemashanu. Kusveta bhegi nemhinduro kuti uve nechokwadi chekuti iwe uwane yakazara yakazara Rituxan inotora imwe gumi nemashanu maminetsi.

Yako yechipiri infusion kurapwa inofanirwa kutora ingangoita awa rimwe zvishoma.

Ndeipi mhedzisiro?

Mumakiriniki miedzo yeRituxan yeRA, vangangoita 18 muzana yevanhu vakave nemhedzisiro. Iyo inowanzoitika mhedzisiro, inosangana panguva uye maawa makumi maviri nemaviri mushure mekumisikidzwa, inosanganisira:

• huro hunyoro kuomesa
• furu-kunge zviratidzo
• mapundu
• kuvava
• dzungu
• kurwadziwa shure
• kugumbuka mudumbu
• kusvotwa
• vangadikitira
• kuomarara kwemhasuru
• huta
• chiveve

Kazhinji iyo jekiseni yesteroid uye antihistamine yaunogamuchira pamberi peiyo infusion inoderedza kuomarara kwemhedzisiro iyi.

Kana iwe uine zvimwe zvakakomba zviratidzo, dana chiremba wako. Izvi zvinogona kusanganisira:

• epamusoro mweya wekufema
• dzihwa
• Urinary turakiti hutachiona
• bronchitis

Fonera chiremba wako ipapo ipapo kana iwe ukaona maonero ekuchinja, kuvhiringidzika, kana kurasikirwa kwehuremu. Kuita kwakakomba kuRituxan hakuwanzo.

Kutora

Rituxan (generic rituximab) yakave FDA-yakatenderwa kurapwa kweRA kubvira 2006. About 1 mu3 vanhu vanorapwa RA havapindure zvakakwana kune mamwe marapirwo ebiologic. Saka Rituxan inopa imwe nzira inogona. Kubva muna2011, vanhu vanopfuura zviuru zana vane RA pasi rese vakagamuchira rituximab.

Kana iwe uri mumiriri weRituxan, verenga pamusoro pekushanda kwayo kuitira kuti iwe ugone kuita sarudzo ine ruzivo. Iwe uchafanirwa kuyeranisa mabhenefiti uye zvingangoita njodzi maringe nekumwe kurapwa (senge minocyline kana mishonga mitsva mukuvandudza). Kurukurai nezvehurongwa hwenyu hwekurapa nachiremba wako.