Kulowetsedwa kwa Rituxan kwa nyamakazi ya nyamakazi: Zomwe Muyenera Kuyembekezera

Zamkati

• Chidule
• Ndani ali woyenera kulandira chithandizo ichi?
• Kodi kafukufukuyu akuti chiyani?
• Kodi Rituxan ya RA imagwira ntchito bwanji?
• Zomwe muyenera kuyembekezera pakulowetsedwa
• Zotsatira zake ndi ziti?
• Kutenga

Chidule

Rituxan ndi mankhwala a biologic omwe amavomerezedwa ndi omwe akuvomerezedwa ndi US Food and Drug Administration (FDA) mu 2006 kuti athetse nyamakazi (RA). Dzina lake lenileni ndi rituximab.

Anthu omwe ali ndi RA omwe sanayankhe mitundu ina yamankhwala amatha kugwiritsa ntchito Rituxan kuphatikiza mankhwala a methotrexate.

Rituxan ndi madzi opanda mtundu woperekedwa ndi kulowetsedwa. Ndi mankhwala otengera kubadwa omwe amalimbana ndi ma B omwe amatenga nawo gawo pakukhudzidwa kwa RA. A FDA adavomerezanso Rituxan ya non-Hodgkin's lymphoma, matenda a khansa ya m'magazi, ndi granulomatosis ndi polyangiitis.

Onse rituximab ndi methotrexate, omwe amapondereza chitetezo cha mthupi, adayamba kupanga ndikugwiritsa ntchito ngati mankhwala a khansa. Rituxan imapangidwa ndi Genentech. Ku Europe, imagulitsidwa ngati MabThera.

Ndani ali woyenera kulandira chithandizo ichi?

A FDA avomereza chithandizo ndi Rituxan ndi methotrexate:

• ngati muli ndi RA yovuta kwambiri
• ngati simunayankhe bwino kuchipatala ndi omwe amatsekereza zotupa za necrosis factor (TNF)

A FDA amalangiza kuti Rituxan iyenera kugwiritsidwa ntchito panthawi yapakati pokhapokha phindu lomwe mayi angapeze lingapose chiopsezo chilichonse kwa mwana wosabadwa. Chitetezo cha Rituxan chogwiritsa ntchito ana kapena amayi oyamwitsa sichinakhazikitsidwe.

A FDA amalimbikitsa motsutsana ndi kugwiritsa ntchito Rituxan kwa anthu omwe ali ndi RA omwe sanalandire chithandizo ndi m'modzi kapena angapo oletsa TNF.

Rituxan siyiyeneranso kulimbikitsidwa kwa anthu omwe ali ndi matenda a chiwindi a B kapena ali ndi kachilomboka, chifukwa Rituxan ikhoza kuyambitsa matenda a chiwindi a B.

Kodi kafukufukuyu akuti chiyani?

Kuchita bwino kwa rituximab mu kafukufukuyu kunali. Mayesero ena azachipatala adatsata.

Kuvomerezeka kwa FDA pakugwiritsa ntchito Rituxan RA kunachokera pamaphunziro atatu akhungu omwe amayerekezera mankhwala a rituximab ndi methotrexate ndi placebo ndi methotrexate.

Chimodzi mwa kafukufukuyu chinali kafukufuku wazaka ziwiri wotchedwa REFLEX (Randomized Evaluation of Long-Term Performance of Rituximab in RA).Kuchita bwino kunayesedwa pogwiritsa ntchito kuwunika kwa American College of Rheumatology (ACR) pakusintha kwa mgwirizano ndi kutupa.

Anthu omwe adalandira rituximab anali ndi ma infusions awiri, patadutsa milungu iwiri. Pambuyo pa masabata 24, REFLEX adapeza kuti:

• 51% ya anthu omwe amathandizidwa ndi rituximab poyerekeza ndi 18% omwe amathandizidwa ndi placebo adawonetsa kusintha kwa ACR20
• 27% ya anthu omwe amathandizidwa ndi rituximab poyerekeza ndi 5% ya anthu omwe amathandizidwa ndi placebo adawonetsa kusintha kwa ACR50
• 12% ya anthu omwe amathandizidwa ndi rituximab poyerekeza ndi 1% ya anthu omwe amathandizidwa ndi placebo adawonetsa kusintha kwa ACR70

Manambala a ACR pano akutanthauza kusintha kuchokera kuzizindikiro zoyambira za RA.

Anthu omwe amathandizidwa ndi rituximab adasintha kwambiri pazizindikiro zina monga kutopa, kulumala, komanso moyo wabwino. Ma X-ray adawonetsanso chizolowezi chochepera kulumikizana pang'ono.

Anthu ena mu phunziroli adakumana ndi zovuta, koma izi zinali zovuta pang'ono.

kuyambira 2006 apezanso zabwino zofananira ndi chithandizo cha rituximab ndi methotrexate.

Kodi Rituxan ya RA imagwira ntchito bwanji?

Njira yothandizira rituximab pochiza RA ndi matenda ena. Amakhulupirira kuti ma rituximab antibodies amalimbana ndi molekyulu (CD20) pamwamba pamaselo ena a B omwe amalumikizidwa ndi njira yotupa ya RA. Maselo a B awa amalingaliridwa kuti amatenga nawo mbali pakupanga rheumatoid factor (RF) ndi zinthu zina zomwe zimakhudzana ndi kutupa.

Rituximab imawonedwa pakanthawi kochepa koma kochepetsetsa kwama cell a B m'magazi ndikuwonongeka pang'ono m'mafupa ndi minofu. Koma maselo a Bwa amabwereranso. Izi zitha kufuna kupitilizidwa kulandira mankhwala a rituximab.

Kafukufuku akupitiliza kufufuza momwe ma rituximab ndi ma B amagwirira ntchito ku RA.

Zomwe muyenera kuyembekezera pakulowetsedwa

Rituxan imaperekedwa ndikudontha mumtsempha (kulowetsedwa mkati, kapena IV) mchipatala. Mlingowo ndi ma infusions a 1,000-milligram (mg) olekanitsidwa ndi milungu iwiri. Kulowetsedwa kwa Rituxan sikumva kuwawa, koma mutha kukhala ndi vuto lodana ndi mankhwalawa.

Dokotala wanu adzawona thanzi lanu asanakupatseni mankhwala ndikukuyang'anirani mukamulowetsedwa.

Hafu ya ola kulowetsedwa kwa Rituxan kukayamba, mupatsidwa kulowetsedwa kwa 100 mg wa methylprednisolone kapena steroid yofananira komanso antihistamine ndi acetaminophen (Tylenol). Izi zikulimbikitsidwa kuti zithandizire kuchepetsa zomwe zingachitike pakulowetsedwa.

Kulowetsedwa kwanu koyamba kumayamba pang'onopang'ono pamlingo wa 50 mg pa ola limodzi, ndipo adotolo apitiliza kuwona zizindikilo zanu zofunikira kuti muwonetsetse kuti simukumana ndi vuto lililonse pakulowetsedwa.

Njira yoyamba kulowetsedwa imatha kutenga pafupifupi maola 4 ndi mphindi 15. Kuthira chikwamacho ndi yankho loti muwonetsetse kuti mwalandira Rituxan kwathunthu kumatenga mphindi 15.

Chithandizo chanu chachiwiri cholowetsedwa chikuyenera kutenga ola limodzi pang'ono.

Zotsatira zake ndi ziti?

M'mayeso azachipatala a Rituxan a RA, pafupifupi 18% ya anthu adakumana ndi zovuta. Zotsatira zoyipa kwambiri, zomwe zimachitika mkati ndi maola 24 mutalowetsedwa, zimaphatikizapo:

• kukhwimitsa pang'ono
• zizindikiro ngati chimfine
• zidzolo
• kuyabwa
• chizungulire
• kupweteka kwa msana
• kukhumudwa m'mimba
• nseru
• thukuta
• kuuma minofu
• manjenje
• dzanzi

Nthawi zambiri jakisoni wa steroid ndi antihistamine yomwe mumalandira isanalowetsedwe imachepetsa kuopsa kwa zotsatirazi.

Ngati muli ndi zizindikiro zowopsa, itanani dokotala wanu. Izi zingaphatikizepo:

• matenda opatsirana apamwamba
• chimfine
• matenda opatsirana mumkodzo
• chifuwa

Itanani dokotala wanu nthawi yomweyo ngati mukuwona masomphenya, kusokonezeka, kapena kuchepa. Zochitika zazikulu ku Rituxan ndizochepa.

Kutenga

Rituxan (generic rituximab) wakhala akuvomerezedwa ndi FDA kuti amuthandize RA kuyambira 2006. Pafupifupi 1 mwa anthu atatu omwe amathandizidwa ndi RA samayankha mokwanira kuchipatala china. Chifukwa chake Rituxan imapereka njira ina. Kuyambira mu 2011, anthu opitilira 100,000 omwe ali ndi RA padziko lonse lapansi adalandira rituximab.

Ngati mukufuna Rituxan, werengani momwe zingagwiritsire ntchito chisankho kuti mupange chisankho chanzeru. Muyenera kuyeza maubwino ndi zoopsa zomwe zingakhalepo poyerekeza ndi mankhwala ena (monga minocyline kapena mankhwala atsopano pakukula). Kambiranani zomwe mungachite ndi dokotala wanu.