Ziphi iziyobisi zeBiologic njengesiKhetho seZifo zikaCrohn?

Umxholo

• Yintoni iziyobisi zebhayoloji?
• Iintlobo ezintathu zebhayoloji
• Amayeza okulwa ne-TNF
• I-Interleukin inhibitors
• Amachiza alwa nokudibanisa
• Inyathelo lokuya phezulu xa kuthelekiswa nonyango oluphezulu
• Imiphumela
• Ukuqwalaselwa okhethekileyo
• Isifo sephepha
• Usulelo
• Iimeko zentliziyo
• Eminye imiba

Ushwankathelo

Isifo sikaCrohn sibangela ukudumba, ukudumba, kunye nokucaphuka kwimigca yendlela yokwetyisa.

Ukuba ukhe wazama ezinye iindlela zonyango lwesifo sikaCrohn, okanye nokuba sele ufunyanisiwe, ugqirha wakho unokucinga ngokumisela amachiza e-biologic. I-Biologics ngamachiza amiselweyo anceda ukunciphisa ukudumba okuyingozi kwisifo sikaCrohn.

Yintoni iziyobisi zebhayoloji?

I-Biologics ngamayeza enziwe ngofuzo ajolise kwiimolekyuli ezithile emzimbeni ochaphazelekayo ekubangeleni ukudumba.

Oogqirha bahlala bemisela i-biologics kwabo bane-Refractory Crohn's disease engaphenduliyo kwamanye amayeza, okanye kubantu abaneempawu ezinzima.Ngaphambi kwe-biologics, zazimbalwa iindlela zonyango ezingafunekiyo kubantu abanesifo esichasayo.

Amachiza e-Biologic asebenza ngokukhawuleza ukuzisa ukuxolelwa. Ngexesha lokuxolelwa, ukudumba kunye neempawu zamathumbu ziyahamba. I-Biologics ingasetyenziselwa ixesha elide ukunceda ukugcina ixesha lokuxolelwa.

Iintlobo ezintathu zebhayoloji

Uhlobo lwe-biologic olucebiswa ngugqirha wakho luya kuxhomekeka kubukhali beempawu zakho kunye nendawo ekuyo isifo. Wonke umntu wahlukile. Iyeza elithile lebhayoloji linokusebenzela bhetele abanye kunabanye. Kuya kufuneka uzame amayeza ambalwa ngaphambi kokufumana okusebenzayo kuwe.

Unyango lwebhayoloji lwesifo sikaCrohn luwela kwelinye lala macandelo mathathu: unyango lwe-anti-tumor necrosis factor (anti-TNF), i-interleukin inhibitors, kunye ne-anti-integrin antibodies.

Unyango oluchasene ne-TNF lujolise kwiprotheni ebandakanyeka kukudumba. Kwisifo sikaCrohn, unyango oluchasene ne-TNF lusebenza ngokuthintela ukudumba okubangelwa yile proteni emathunjini.

I-Interleukin inhibitors isebenza ngokufanayo, ngokuthintela iiprotein ezivela ngokwendalo ezibangela ukudumba emathunjini. I-anti-integrins ibhloka iiseli ezithile zamajoni omzimba ezibangela ukudumba.

I-Biologics inikezelwa ngokunqamlezayo (ngenaliti ngesikhumba) okanye nge-intravenously (ngokusebenzisa ityhubhu ye-IV). Banokunikwa rhoqo emva kweeveki ezimbini ukuya kwezisibhozo, kuxhomekeke kunyango. Kuya kufuneka uye esibhedlele okanye ekliniki uninzi lonyango.

I-FDA ivume iziyobisi ezininzi zokunyanga isifo sikaCrohn.

Amayeza okulwa ne-TNF

• i-adalimumab (Humira, Exemptia)
• isatifikethi sepgol (Cimzia)
• infliximab (Remicade, Remsima, Inflectra)

I-Interleukin inhibitors

• ustekinumab (uStelara)

Amachiza alwa nokudibanisa

• natalizumab (iTysabri)
• vedolizumab (Entyvio)

Inyathelo lokuya phezulu xa kuthelekiswa nonyango oluphezulu

Unyango lwebhayoloji lunokuba sisixhobo esinamandla kunyango kunye nolawulo lwesifo sikaCrohn. Kukho iindlela ezimbini ezahlukeneyo kunyango lwebhayoloji:

• Inyathelo lokunyanga yayiyindlela yesiqhelo de kwakhishwa izikhokelo ezitsha ngo-2018. Le ndlela ithetha ukuba wena nogqirha wakho nizame ezinye iindlela zonyango ngaphambi kokuqala i-biologic.
• Unyango oluphezulu-phezulu luthetha ukuba amayeza e-biologic aqalisiwe kwangoko kwinkqubo yonyango. Le yeyona ndlela ikhethwayo kwiimeko ezininzi zokumodareyitha isifo esiqatha sikaCrohn.

Nangona kunjalo, iindlela ezahlukeneyo zinokusebenza ngcono kubantu abohlukeneyo ngokuxhomekeke kubukrakra nakwindawo esihlala kuyo esi sifo.

Imiphumela

I-Biologics ithambekele ekubeni neziphumo ebezingalindelekanga ezimbalwa ezingqwabalala kunezinye iziyobisi zesifo sikaCrohn, ezinje ngecorticosteroids, ecinezela amajoni omzimba onke.

Okwangoku, kukho iziphumo ebezingalindelekanga ezithile ekufuneka uyazi ngaphambi kokuthatha iyeza lebhayoloji.

Ezinye iziphumo ebezingalindelekanga eziqhelekileyo zebhayoloji zibandakanya:

• ububomvu, ukurhawuzelela, ukutyumka, iintlungu, okanye ukudumba ujikeleze indawo yenaliti
• intloko ebuhlungu
• umkhuhlane okanye ukubanda
• ubunzima bokuphefumla
• uxinzelelo lwegazi oluphantsi
• urhashalala okanye irhashalala
• isisu esibuhlungu
• umqolo obuhlungu
• isicaphucaphu
• ukukhohlela okanye umqala obuhlungu

Ukuqwalaselwa okhethekileyo

I-Biologics ayinakukhuseleka kuwo wonke umntu. Thetha nogqirha wakho ukuba unesifo sephepha (TB), uqhele ukosulelwa zizifo, okanye unesifo sentliziyo.

Isifo sephepha

Amachiza e-Biologic asetyenziselwa isifo sikaCrohn anokunyusa umngcipheko wokuphinda usebenze isifo se-TB kubantu abaye bavezwa. I-TB sisifo esibi esosulelayo semiphunga.

Ugqirha wakho kufuneka akuvavanyele i-TB ngaphambi kokuba aqale unyango nge-biologic. Usulelo lwe-TB lunokulala emzimbeni. Abanye abantu abaye bavezwa sesi sifo banokungazi.

Ukuba ukhe wabhencwa yi-TB ngaphambili, ugqirha wakho unokucebisa unyango lwe-TB ngaphambi kokuba athathe i-biologic.

Usulelo

I-Biologics inganciphisa amandla omzimba okulwa nezinye izifo. Ukuba uthambekele kusulelo, ugqirha wakho unokucebisa uhlobo olwahlukileyo lonyango.

Iimeko zentliziyo

Amayeza okulwa ne-TNF anokuba yingozi kubantu abaneemeko ezithile zentliziyo, ezinje ngokusilela kwentliziyo. Ukungaphumeleli kwentliziyo kuxa intliziyo ingakwazi ukumpompa igazi elaneleyo ukuhlangabezana neemfuno zomzimba.

Tshela ugqirha wakho ngokukhawuleza ukuba ufumana ukuphefumula okufutshane okanye ukuvuvukala kweenyawo ngelixa uthatha i-biologic yesifo sikaCrohn. Oku kunokuba yimiqondiso yokusilela kwentliziyo.

Eminye imiba

Unyango lwebhayoloji ngamanye amaxesha lunxulunyaniswa neengxaki ezinzulu zempilo. Kubantu abathatha amachiza e-biologic, ezi ngxaki zempilo zilandelayo azifane zichazwe:

• ukuphazamiseka kwegazi okuthile (ukugruzuka, ukopha)
• iingxaki zemithambo-luvo (kubandakanya, ukuba ndindisholo, ubuthathaka, ukurhawuzelela, okanye ukuphazamiseka okubonakalayo, njengokubona okungaboniyo, umbono ophindwe kabini, okanye ukungaboni kakuhle)
• lymphoma
• ukulimala kwesibindi
• negazi kakhulu

Thetha nogqirha wakho ukumisela olona nyango lulungileyo kuwe kunye neemfuno zakho.