Zomwe Muyenera Kudziwa Zokhudza Masamba Atsopano a Psoriasis

Zamkati

• Zatsopano zamoyo
• Risankizumab-rzaa (Skyrizi)
• Chitsimikizo cha pegol (Cimzia)
• Tildrakizumab-asmn (Ilumya)
• Guselkumab (Tremfya)
• Brodalumab (Siliq)
• Ixekizumab (Taltz)
• Zolemba
• Biosimilars to adalimumab (Humira)
• Biosimilars kuti etanercept (Enbrel)
• Biosimilars kuti infliximab (Remicade)
• Mankhwala atsopano apakhungu
• Mafuta a Halobetasol propionate-tazarotene, 0.01% / 0.045% (Duobrii)
• Thovu la Halobetasol propionate, 0.05% (Lexette)
• Mafuta odzola a Halobetasol, 0.01% (Bryhali)
• Utsi wa Betamethasone dipropionate, 0.05% (Sernivo)
• Mankhwala atsopano a ana
• Chithovu cha Calcipotriene, 0.005% (Sorilux)
• Calcipotriene-betamethasone dipropionate thovu, 0.005% / 0.064% (Enstilar)
• Calcipotriene-betamethasone dipropionate kuyimitsidwa kwamutu, 0.005% / 0.064% (Taclonex)
• Ustekinumab (Stelara)
• Etanercept (Enbrel)
• Mankhwala ena akuyandikira kuvomerezedwa
• Bimekizumab
• Kirimu ya calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Wynzora)
• Zoletsa za JAK
• Tengera kwina

Ochita kafukufuku aphunzira zambiri m'zaka zaposachedwa za psoriasis ndi momwe chitetezo cha mthupi chimasewera potere. Zatsopano zatsopanozi zadzetsa mankhwala otetezeka a psoriasis, otsogozedwa, komanso othandiza.

Ngakhale zochiritsira zonse zilipo, kafukufuku akuwonetsa kuti anthu ambiri omwe amalandila psoriasis sakhutira ndi chithandizo chawo kapena amakhutitsidwa pang'ono.

Ngati mukuyang'ana kuti musinthe mankhwalawa chifukwa omwe mukugwirayu sakugwiranso ntchito kapena mukukumana ndi zovuta zina, ndibwino kuti muphunzire zambiri pazomwe mungasankhe posachedwa.

Zatsopano zamoyo

Biologics amapangidwa kuchokera kuzinthu zopezeka m'zinthu zamoyo, monga mapuloteni, shuga, kapena ma nucleic acid. Kamodzi mthupi, mankhwalawa amaletsa gawo limodzi lama chitetezo chamthupi lomwe limathandizira kuzindikiritsa psoriasis yanu.

Biologics imasokoneza izi:

• chotupa necrosis factor alpha (TNF-alpha), yomwe ndi protein yomwe imalimbikitsa kutupa mthupi
• Maselo a T, omwe ndi maselo oyera a magazi
• interleukins, omwe ndi ma cytokines (mapuloteni ang'onoang'ono otupa) omwe amakhala ndi psoriasis

Kulowerera kumeneku kumathandiza kuchepetsa kutupa.

Risankizumab-rzaa (Skyrizi)

Risankizumab-rzaa (Skyrizi) idavomerezedwa ndi Food and Drug Administration (FDA) mu Epulo 2019.

Amapangidwira anthu omwe ali ndi psoriasis yolemera pang'ono kapena ovuta omwe amafunafuna phototherapy (light therapy) kapena systemic (thupi lonse).

Skyrizi imagwira ntchito poletsa zochita za interleukin-23 (IL-23).

Mlingo uliwonse umakhala ndi majakisoni awiri ochepera (pansi pa khungu). Mlingo woyamba wagawanika patadutsa milungu inayi. Zina zonse zimaperekedwa kamodzi pa miyezi itatu iliyonse.

Zotsatira zoyipa za Skyrizi ndi izi:

• matenda opatsirana apamwamba
• zochita pa malo opangira jekeseni
• mutu
• kutopa
• mafangasi matenda

Chitsimikizo cha pegol (Cimzia)

A FDA adavomereza certolizumab pegol (Cimzia) ngati mankhwala a psoriasis mu Meyi 2018. Anali atavomerezedwa kale kuti azichiza matenda ngati Crohn's disease ndi psoriatic arthritis (PsA).

Cimzia amachiza psoriasis yolimbitsa thupi kwambiri mwa anthu omwe amafunafuna phototherapy kapena systemic therapy. Zimagwira ntchito polimbana ndi mapuloteni a TNF-alpha.

Mankhwalawa amaperekedwa ngati majakisoni awiri amkati mwa sabata iliyonse.

Zotsatira zoyipa kwambiri za Cimzia ndi izi:

• matenda opatsirana apamwamba
• zidzolo
• matenda opatsirana mumkodzo (UTIs)

Tildrakizumab-asmn (Ilumya)

Tildrakizumab-asmn (Ilumya) idavomerezedwa ndi FDA mu Marichi 2018. Amagwiritsidwa ntchito pochizira psoriasis ya plaque mwa akulu omwe amafunsidwa ndi phototherapy kapena systemic therapy.

Mankhwalawa amagwira ntchito poletsa IL-23.

Ilumya amaperekedwa ngati jakisoni wa subcutaneous. Majekeseni awiri oyamba amakhala osiyana pakadutsa milungu inayi. Kuyambira pamenepo, jakisoni amapatsidwa miyezi itatu popanda.

Zotsatira zoyipa za Ilumya ndi izi:

• zochita pa malo opangira jekeseni
• matenda opatsirana apamwamba
• kutsegula m'mimba

Guselkumab (Tremfya)

Guselkumab (Tremfya) idavomerezedwa ndi FDA mu Julayi 2017. Amagwiritsidwa ntchito pochizira psoriasis yolimbitsa thupi mwa anthu omwe amafunikiranso Phototherapy kapena mankhwala amachitidwe.

Tremfya anali woyamba biologic kutsata IL-23.

Mlingo woyambira woyamba wapatsidwa milungu inayi kutalikirana. Pambuyo pake, Tremfya amapatsidwa ngati jakisoni wochepera m'masabata asanu ndi atatu.

Zotsatira zofala kwambiri zimaphatikizapo:

• mutu
• matenda opatsirana apamwamba
• zochita pa malo opangira jekeseni
• kupweteka pamodzi
• kutsegula m'mimba
• chimfine m'mimba

Brodalumab (Siliq)

Brodalumab (Siliq) idavomerezedwa ndi FDA mu February 2017. Amapangidwira anthu omwe amakwaniritsa izi:

• khalani ndi chipika chachikulu cha psoriasis
• ndi ofuna kulandira chithandizo chamankhwala kapena chithandizo chamagetsi
• psoriasis yawo siyiyankha mankhwala ena amachitidwe

Zimagwira ntchito pomangiriza kwa IL-17 receptor. Njira ya IL-17 imagwira ntchito yotupa ndipo imakhudzidwa ndikupanga ma psoriasis plaque.

M'mayeso azachipatala, omwe adathandizidwa ndi Siliq anali othekera kwambiri kuposa omwe adalandira malowa kuti akhale ndi khungu lomwe limawoneka kuti limamveka bwino.

Siliq amaperekedwa ngati jakisoni. Ngati dokotala wanu akukulemberani mankhwalawa, mudzalandira jakisoni kamodzi pamlungu pamasabata atatu oyambilira. Pambuyo pake, mudzalandira jakisoni m'modzi milungu iwiri iliyonse.

Monga ma biologics ena, Siliq amachulukitsa chiopsezo chotenga kachilombo. Chizindikiro cha mankhwalawa chimakhalanso ndi bokosi lakuda lochenjeza za chiopsezo chachikulu chofuna kudzipha.

Anthu omwe ali ndi mbiri yakudzipha kapena kukhumudwa ayenera kuyang'aniridwa akamamwa brodalumab.

Ixekizumab (Taltz)

Ixekizumab (Taltz) idavomerezedwa ndi FDA mu Marichi 2016 kuti ichiritse achikulire omwe ali ndi psoriasis yochepa. Amapangidwira anthu omwe akufuna kulandira chithandizo cha phototherapy, systemic therapy, kapena onse awiri.

Taltz amalimbana ndi mapuloteni IL-17A.

Ndi mankhwala obaya jakisoni. Mudzalandira jakisoni awiri patsiku lanu loyamba, jakisoni milungu iwiri iliyonse kwa miyezi itatu yotsatira, ndi jakisoni milungu inayi iliyonse pamankhwala anu otsala.

Chivomerezocho chinali potengera zotsatira za maphunziro angapo azachipatala omwe anali nawo onse 3,866. M'maphunziro amenewo, anthu ambiri omwe amamwa mankhwalawa adapeza khungu lomwe linali lomveka bwino.

Zotsatira zofala kwambiri za Taltz ndizo:

• matenda opatsirana apamwamba
• zochita pa malo opangira jekeseni
• mafangasi matenda

Zolemba

Biosimilars sizofanana kwenikweni ndi biologics. M'malo mwake, amasinthidwa kuti apange zotsatira zofananira ndi biologics.

Monga mankhwala achibadwa, ma biosimilars amapangidwa kamodzi pomwe biologic yoyambirira ichoka patent. Ubwino wama biosimilars ndikuti nthawi zambiri amawononga ndalama zochepa kwambiri kuposa zoyambirira.

Biosimilars a psoriasis ndi awa:

Biosimilars to adalimumab (Humira)

• adalimumab-adaz (Hyrimoz)
• adalimumab-adbm (Cyltezo)
• adalimumab-afzb (Abrilada)
• adalimumab-atto (Amjevita)
• adalimumab-bwwd (Hadlima)

Biosimilars kuti etanercept (Enbrel)

• etanercept-szzs (Erelzi)
• Etanercept-ykro (Eticovo)

Biosimilars kuti infliximab (Remicade)

• infliximab-abda (Renflexis)
• infliximab-axxq (Avsola)
• infliximab-dyyb (Chofunika)

Remicade biosimilar Inflectra anali woyamba psoriasis biosimilar kulandira chivomerezo cha FDA. Munali mu Epulo 2016.

Inflectra ndi Renflexis, mtundu wina wa Remicade biosimilar, ndi okhawo omwe akupezeka kugula ku United States. Izi zili choncho makamaka chifukwa setifiketi yomwe opanga ma biologics adachita sinathe.

Mankhwala atsopano apakhungu

Matenda apakhungu, kapena omwe mumadzipaka pakhungu lanu, nthawi zambiri ndiwo mankhwala oyamba omwe madokotala amalimbikitsira psoriasis. Zimagwira ntchito pochepetsa kutupa ndikuchepetsa kuchuluka kwa khungu.

Mafuta a Halobetasol propionate-tazarotene, 0.01% / 0.045% (Duobrii)

Mu Epulo 2019, a FDA adavomereza mafuta a halobetasol propionate-tazarotene, 0,01% / 0.045% (Duobrii) yochizira plaque psoriasis mwa akulu.

Duobrii ndiye mafuta odzola oyamba kuphatikiza corticosteroid (halobetasol propionate) ndi retinoid (tazarotene). Corticosteroid yotsutsana ndi yotupa imachotsa zikwangwani, pomwe vitamini A-retinoid yochepetsera kukula kwa khungu.

Duobrii imagwiritsidwa ntchito kamodzi patsiku kumadera akhungu.

Zotsatira zake zoyipa ndi izi:

• kupweteka pamalo ogwiritsira ntchito
• zidzolo
• folliculitis, kapena tsitsi lotupa
• kuvala khungu komwe kumadzola mafuta
• kudzikweza, kapena kutola khungu

Thovu la Halobetasol propionate, 0.05% (Lexette)

Halobetasol propionate foam, 0.05% ndi topical corticosteroid yomwe a FDA adavomereza koyamba, ngati generic, mu Meyi 2018. Mu Epulo 2019, idayamba kupezeka pansi pa dzina la Lexette.

Amagwiritsidwa ntchito pochizira plaque psoriasis mwa akulu. Cholinga chake ndikutsuka khungu.

Kawiri patsiku, thovu limapakidwa pakhosi lochepa ndikupaka pakhungu. Lexette itha kugwiritsidwa ntchito mpaka milungu iwiri.

Zotsatira zoyipa kwambiri za Lexette ndizopweteka patsamba logwiritsira ntchito komanso mutu.

Mafuta odzola a Halobetasol, 0.01% (Bryhali)

Mafuta a Halobetasol propionate, 0,01% (Bryhali) adavomerezedwa ndi a FDA mu Novembala 2018. Amapangidwira achikulire omwe ali ndi plaque psoriasis.

Zina mwazizindikiro zomwe zimathandizira kuthana ndi izi:

• kuuma
• akuyenda
• kutupa
• chipika chomanga

Bryhali amagwiritsidwa ntchito tsiku lililonse. Mafutawa amatha kugwiritsidwa ntchito mpaka milungu 8.

Zotsatira zoyipa kwambiri ndi izi:

• kuyaka
• mbola
• kuyabwa
• kuuma
• matenda opatsirana apamwamba
• shuga wambiri wamagazi

Utsi wa Betamethasone dipropionate, 0.05% (Sernivo)

Mu February 2016, a FDA adavomereza betamethasone dipropionate spray, 0.05% (Sernivo). Tsambali limagwiritsa ntchito psoriasis yofatsa mpaka yaying'ono mwa anthu azaka za 18 kapena kupitilira apo.

Sernivo imathandiza kuthetsa zizindikiro za psoriasis monga kuyabwa, kuphulika, ndi kufiira.

Mumathira mankhwala a corticosteroid pakhungu kawiri patsiku ndikuwapaka mokoma. Atha kugwiritsidwa ntchito mpaka milungu inayi.

Zotsatira zoyipa kwambiri ndi izi:

• kuyabwa
• kuyaka
• mbola
• kupweteka pamalo ogwiritsira ntchito
• khungu khungu

Mankhwala atsopano a ana

Mankhwala ochepa a psoriasis omwe kale anali okhudzana ndi akulu adangovomerezedwa ndi FDA kuti nawonso athandizire ana.

Chithovu cha Calcipotriene, 0.005% (Sorilux)

Mu 2019, a FDA adakulitsa kuvomereza kwawo mtundu wa vitamini D wotchedwa calcipotriene foam, 0.005% (Sorilux). Amagwiritsidwa ntchito pochizira plaque psoriasis ya khungu ndi thupi.

Mu Meyi, idalandira chilolezo chogwiritsa ntchito ana azaka za 12 mpaka 17 zakubadwa. Novembala lotsatira, zidavomerezedwa kuti zithandizire plaque psoriasis ya khungu ndi thupi mwa ana omwe ali ndi zaka 4.

Sorilux imathandizira kuchepa kwamaselo akhungu osazolowereka mu psoriasis. Chithovu ichi chimagwiritsidwa ntchito pakhungu lomwe lakhudzidwa kawiri patsiku kwa milungu 8. Ngati zizindikiro sizikusintha pakatha masabata 8, funsani dokotala wanu.

Zotsatira zoyipa kwambiri ndizofiyira komanso kupweteka patsamba lofunsira.

Calcipotriene-betamethasone dipropionate thovu, 0.005% / 0.064% (Enstilar)

Mu Julayi 2019, FDA idavomereza thovu la calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Enstilar) yogwiritsidwa ntchito kwa achinyamata azaka zapakati pa 12 ndi 17. Amapangidwira anthu omwe ali ndi plaque psoriasis.

Calcipotriene imachedwetsa kukula kwa khungu, pomwe betamethasone dipropionate imathandizira kuchepetsa kutupa.

Chithovu chimagwiritsidwa ntchito tsiku lililonse mpaka milungu inayi.

Zotsatira zoyipa kwambiri ndi izi:

• kuyabwa
• folliculitis
• zidzolo ndi zotupa zofiira kapena ming'oma
• kukulitsa psoriasis

Calcipotriene-betamethasone dipropionate kuyimitsidwa kwamutu, 0.005% / 0.064% (Taclonex)

Mu Julayi 2019, kuyimitsidwa kwamatenda a calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Taclonex) idavomerezedwanso ndi FDA kuti igwiritsidwe ntchito kwa azaka zapakati pa 12 mpaka 17 okhala ndi plaque psoriasis ya thupi.

Kuyimitsidwa kwamutuwu kunali kovomerezedwa kale ndi FDA kwa azaka zapakati pa 12 ndi 17 okhala ndi plaque psoriasis yakumutu. Mafuta a Taclonex anali atavomerezedwa kale ndi FDA kwa achinyamata komanso achikulire omwe ali ndi plaque psoriasis.

Kuyimitsidwa kwamatope a Taclonex kumagwiritsidwa ntchito tsiku lililonse kwa milungu isanu ndi itatu. Kwa azaka zapakati pa 12 mpaka 17, mulingo wokwanira sabata iliyonse ndi magalamu 60 (g). Mlingo waukulu wa mlungu uliwonse kwa akulu ndi 100 g.

Zotsatira zoyipa kwambiri ndi izi:

• kuyabwa
• kuyaka
• kuyabwa
• kufiira
• folliculitis

Ustekinumab (Stelara)

Mu Okutobala 2017, a FDA adavomereza ustekinumab (Stelara) ya achinyamata azaka 12 kapena kupitilira apo. Itha kugwiritsidwa ntchito kwa achinyamata omwe ali ndi zolembera zolimbitsa thupi zolimbitsa thupi zomwe zimafunikira phototherapy kapena systemic therapy.

Chivomerezocho chinabwera kafukufuku wa 2015 atapeza kuti mankhwalawa adatsuka khungu pakatha miyezi itatu. Ponena za kuyeretsa khungu ndi chitetezo, zotsatira zinali zofanana ndi zomwe zimawoneka mwa akuluakulu.

Stelara amatseka mapuloteni awiri omwe ndi ofunikira pakhungu, IL-12 ndi IL-23.

Amapatsidwa ngati jakisoni wocheperako. Kusankha kumachokera kulemera kwa thupi:

• Achinyamata omwe amalemera makilogalamu ochepera 60 (mapaundi 132) amalandira mamiligalamu 0.75 (mg) pa kilogalamu yolemera.
• Achinyamata omwe amalemera pakati pa 60 kg (132 lbs.) Ndi 100 kg (220 lbs.) Amalandila 45-mg.
• Achinyamata omwe amalemera makilogalamu oposa 100 (220 lbs.) Amatenga 90 mg, womwe ndi mulingo woyenera wa anthu olemera omwewo.

Mlingo woyamba wapatsidwa milungu inayi kutalikirana. Pambuyo pake, mankhwalawa amaperekedwa kamodzi miyezi itatu iliyonse.

Zotsatira zoyipa kwambiri ndi izi:

• chimfine ndi matenda ena am'mapapo
• mutu
• kutopa

Etanercept (Enbrel)

Mu Novembala 2016, a FDA adavomereza etanercept (Enbrel) kuti athe kuchiza psoriasis yayikulu kwambiri kwa ana azaka 4 mpaka 17 omwe akufuna kulandira phototherapy kapena systemic therapy.

Enbrel wavomerezedwa kuti azisamalira achikulire omwe ali ndi plaque psoriasis kuyambira 2004 komanso kuti azichiza ana omwe ali ndi matenda a ana aamuna (JIA) kuyambira 1999.

Mankhwala ojambulidwawa amachepetsa ntchito za TNF-alpha.

Kafukufuku wa 2016 wa ana pafupifupi 70 azaka zapakati pa 4 mpaka 17 adapeza kuti Enbrel anali otetezeka ndipo adagwirabe ntchito mpaka zaka 5.

Mlungu uliwonse, ana ndi achinyamata amalandira 0.8 mg ya mankhwalawa pa kilogalamu ya thupi lawo. Mlingo waukulu womwe dokotala angamupatse ndi 50 mg pa sabata, womwe ndi mulingo woyenera wa akulu.

Zotsatira zoyipa kwambiri ndizomwe zimachitika patsamba la jakisoni ndi matenda opatsirana apamwamba.

Mankhwala ena akuyandikira kuvomerezedwa

Mankhwala ena akuyandikira kuvomerezedwa ndi FDA.

Bimekizumab

Bimekizumab ndi mankhwala ojambulidwa a biologic omwe akuyesedwa ngati chithandizo cha psoriasis yosalekeza. Zimagwira ntchito poletsa IL-17.

Bimekizumab pakadali pano ali m'maphunziro a gawo lachitatu. Pakadali pano, kafukufuku wasonyeza kuti ndiwotetezeka komanso wogwira ntchito.

M'mayeso a BE SURE achipatala, bimekizumab inali yothandiza kwambiri kuposa adalimumab (Humira) pothandiza anthu kupeza osachepera 90% pazambiri zomwe zimagwiritsidwa ntchito poyeza kuopsa kwa matenda.

Kirimu ya calcipotriene-betamethasone dipropionate, 0.005% / 0.064% (Wynzora)

Mu 2019, kugwiritsa ntchito mankhwala atsopano kunaperekedwa ku FDA ya Wynzora. Wynzora ndi kirimu kamodzi patsiku chomwe chimaphatikiza calcipotriene ndi betamethasone dipropionate.

Pakafukufuku wachitatu, Wynzora anali othandiza kwambiri pakhungu pakatha masabata asanu ndi atatu kuposa kuyimitsidwa kwa Taclonex komanso kirimu.

Wynzora ali ndi mwayi wokhala wopanda nkhawa, zomwe ophunzirawo adawona kuti ndizosavuta.

Zoletsa za JAK

JAK inhibitors ndi gulu linanso la mankhwala osintha matenda. Amagwira ntchito yolunjika njira zomwe zimathandiza thupi kupanga mapuloteni otupa kwambiri.

Amagwiritsidwa ntchito kale kuchiza:

• nyamakazi ya psoriatic
• nyamakazi
• anam`peza matenda am`matumbo

Ochepa ali mgawo lachiwiri ndi mayeso a gawo lachitatu la psoriasis yochepa. Omwe amaphunziridwa za psoriasis ndi mankhwala am'kamwa tofacitinib (Xeljanz), baricitinib (Olumiant), ndi abrocitinib. A topical JAK inhibitor nawonso amafufuzidwa.

Pakadali pano, kafukufuku wapeza kuti zoletsa za JAK ndizothandiza pa psoriasis. Iwo ndi otetezeka ngati mankhwala omwe alipo kale a biologic. Ubwino wake ndikuti amabwera m'mapiritsi ndipo sayenera kuperekedwa ngati jakisoni.

Kafukufuku yemwe wachitika pakadali pano ndiwanthawi yayifupi. Kafukufuku wowonjezera amafunikira kuti adziwe ngati ma JAK inhibitors akupitilizabe kugwira ntchito kwakanthawi.

Tengera kwina

Kudziwitsidwa za njira zatsopano kwambiri zothandizira psoriasis ndikofunikira pakuwongolera matenda anu.

Palibe mankhwala amtundu umodzi a psoriasis. Zikuwoneka kuti muyenera kuyesa mankhwala osiyanasiyana musanapeze njira yomwe ingakuthandizeni kwambiri ndipo siyimayambitsa zovuta zina.

Zatsopano mu psoriasis zimachitika nthawi zonse. Onetsetsani kuti mwalankhula ndi dokotala za njira zatsopano zamankhwala.