Zisebenza njani iiNyango zomlomo ze-MS Work?
Umxholo
- Indima yeeseli ze-B kunye neeseli zeT
- Cladribine (iMavenclad)
- IDimethyl fumarate (iTecfidera)
- I-Diroximel fumarate (ubungakanani)
- I-Fingolimod (iGilenya)
- I-Siponimod (iMayzent)
- I-Teriflunomide (Aubagio)
- Ezinye iziyobisi eziguqula izifo
- Umngcipheko onokubakho weziphumo ebezingalindelekanga ezivela kwi-DMTs
- Ukulawula umngcipheko weziphumo ebezingalindelekanga
- Ukuthatha
- Yile nto iVakalelwa kukuba ukuPhila nge-MS
I-Multiple sclerosis (MS) kukuphazamiseka komzimba apho amajoni akho omzimba ahlasela isambatho esikhuselekileyo esijikeleze imithambo luvo (CNS). I-CNS ibandakanya ubuchopho bakho kunye nentambo yomqolo.
Unyango oluguqula isifo (i-DMTs) lunyango olucetyiswayo ukunceda ukucothisa ukukhula kwe-MS. Ii-DMTs zinokunceda ukulibaziseka kokukhubazeka kunye nokunciphisa ukuphindaphindeka kwamafutha kubantu abakule meko.
Ulawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) livume ii-DMTs ezininzi zokunyanga iifom ezibuyayo ze-MS, kubandakanya ii-DMTs ezintandathu ezithathwa ngomlomo njengee-capsules okanye iipilisi.
Funda ukuze ufunde ngakumbi nge-DMTs yomlomo kunye nendlela abasebenza ngayo.
Indima yeeseli ze-B kunye neeseli zeT
Ukuqonda ukuba i-DMTS yomlomo inceda njani ukunyanga i-MS, kufuneka uyazi malunga nendima yeeseli ezithile zomzimba kwi-MS.
Iindidi ezininzi zeeseli zomzimba kunye neemolekyuli ziyabandakanyeka kwimpendulo yomzimba engaqhelekanga ebangela ukudumba kunye nomonakalo kwi-MS.
Oku kubandakanya iiseli ze-T kunye neeseli ze-B, iintlobo ezimbini zeeseli ezimhlophe zegazi ezibizwa ngokuba zii-lymphocyte. Ziveliswa kwinkqubo yemithambo-luvo yomzimba wakho.
Xa iiseli ze-T zisuka kwinkqubo yakho ye-lymphatic ziye kwigazi lakho, banokuhamba baye kwi-CNS yakho.
Ezinye iintlobo zeeseli ze-T zivelisa iiproteni ezaziwa ngokuba zii-cytokines, ezibangela ukudumba. Kubantu abane-MS, ii-cytokines ezinamandla okuvuvukala zibangela umonakalo kwi-myelin nakwiiseli zemithambo-luvo.
Iiseli ze-B zivelisa ii-cytokines ezinamandla okuvuvukala, ezinokukunceda ukuqhuba imisebenzi yeeseli ezibangela isifo kwi-MS. Iiseli ze-B zivelisa ii-antibodies, ezinokudlala indima kwi-MS.
Ii-DMTs ezininzi zisebenza ngokunciphisa ukusebenza, ukusinda, okanye ukuhamba kweeseli ze-T, iiseli ze-B, okanye zombini. Oku kunceda ukunciphisa ukudumba kunye nomonakalo kwi-CNS. Ezinye ii-DMTs zikhusela iiseli zemithambo-luvo kumonakalo ngezinye iindlela.
Cladribine (iMavenclad)
I-FDA ivumile ukusetyenziswa kwe-cladribine (Mavenclad) ukunyanga iifom ezibuyela umva ze-MS kubantu abadala. Ukuza kuthi ga ngoku, akukho zifundo zigqityiweyo ngokusetyenziswa kweMavenclad ebantwaneni.
Xa umntu ethatha eli yeza, lingena kwiiseli ze-T nakwiiseli ze-B emzimbeni wabo kwaye liphazamise ukubanakho kweeseli zokwenza nokulungisa iDNA. Oku kubangela ukuba iiseli zife, ukunciphisa inani leeseli T kunye neeseli ze-B kumajoni omzimba.
Ukuba ufumana unyango neMavenclad, uya kuthatha iikhosi ezimbini zeziyobisi ngaphezulu kweminyaka emi-2. Ikhosi nganye iya kubandakanya iiveki ezimbini zonyango, ezahlulwe yinyanga enye.
Ngexesha leveki nganye yonyango, ugqirha wakho uya kukucebisa ukuba uthathe idosi enye okanye ezimbini zemihla ngemihla zeentsuku ezi-4 okanye ezi-5.
IDimethyl fumarate (iTecfidera)
I-FDA ivume i-dimethyl fumarate (Tecfidera) yokunyanga iifom ezibuyayo ze-MS kubantu abadala.
I-FDA ayikamkeli iTecfidera yokunyanga i-MS ebantwaneni. Nangona kunjalo, oogqirha banokuyalela la mayeza kubantwana ngendlela eyaziwa ngokuba yi "off-label".
Nangona uphando oluninzi luyafuneka, uphononongo ukuza kuthi ga ngoku lubonisa ukuba eli chiza likhuselekile kwaye lisebenza ngokunyanga i-MS ebantwaneni.
Iingcali aziyazi kakuhle indlela iTecfidera esebenza ngayo. Nangona kunjalo, abaphandi bafumanise ukuba eli yeza linokunciphisa ubuninzi beentlobo ezithile zeeseli ze-T kunye neeseli ze-B, kunye nee-cytokines ezinamandla okuvuvukala.
I-Tecfidera ikwabonakala ngathi iyayisebenzisa iprotheyini eyaziwa njenge-nuclear factor erythroid 2-related factor (NRF2). Oku kubangela iimpendulo zeselula ezinceda ukukhusela iiseli zemithambo-luvo kuxinzelelo lwe-oxidative.
Ukuba umiselwe iTecfidera, ugqirha wakho uya kukucebisa ukuba uthathe iidosi ezimbini ze-120-milligram (mg) ngosuku ngeentsuku ezisi-7 zokuqala zonyango. Emva kweveki yokuqala, baya kukuxelela ukuba uthathe iidosi ezimbini ezingama-240-mg ngosuku rhoqo.
I-Diroximel fumarate (ubungakanani)
I-FDA ivume i-diroximel fumarate (Ubuninzi) ukunyanga iifom ezibuyayo ze-MS kubantu abadala. Iingcali azikayazi ukuba eli yeza likhuselekile okanye liyasebenza ebantwaneni.
Ubuninzi yinxalenye yeklasi efanayo yamayeza njengeTecfidera. NjengoTecfidera, kukholelwa ukuba iyenza iproteyini i-NRF2. Oku kuseta iimpendulo zeselula ezinceda ukunqanda ukonakala kweeseli zemithambo-luvo.
Ukuba isicwangciso sakho sonyango sibandakanya ukuBala, ugqirha wakho uya kukucebisa ukuba uthathe i-231 mg yeyeza kabini ngemini kwiintsuku ezisi-7 zokuqala. Ukusuka apho ukuya phambili, kuya kufuneka uthathe i-462 mg yeyeza kabini ngemini.
I-Fingolimod (iGilenya)
I-FDA ivume i-fingolimod (i-Gilenya) yokunyanga ukubuyela umva kwe-MS kubantu abadala kunye nabantwana abaneminyaka eli-10 okanye ngaphezulu.
I-FDA ayikawamkeli la mayeza okunyanga abantwana abancinci, kodwa oogqirha banokumisela ukuba angabikho kwilebula kubantwana abangaphantsi kweminyaka eli-10.
Olu nyango luthintela uhlobo lokubonisa imolekyuli eyaziwa ngokuba yi-sphingosine 1-phosphate (S1P) ukusuka ekubophelelweni ukuya kwiiseli ze-T nakwiiseli ze-B. Ngokulandelayo, oku kuthintela ezo seli zingangeni egazini nasekuhambeni ziye kwi-CNS.
Xa ezo seli zimisiwe ekuhambeni ziye kwi-CNS, azinakubangela ukudumba kunye nomonakalo apho.
I-Gilenya ithathwa kanye ngosuku. Kubantu abanobunzima obungaphezu kweeponti ezingama-88 (iikhilogram ezingama-40), idosi yemihla ngemihla ecetyiswayo yi-0.5 mg. Kulabo abanobunzima obungaphantsi koko, idosi yemihla ngemihla ecetyiswayo yi-0.25 mg.
Ukuba uqala unyango ngeli yeza kwaye uyeke ukulisebenzisa, unokufumana isikhuni esibi.
Abanye abantu abane-MS bahlakulele ukonyuka okukhulu kokukhubazeka kunye nezilonda zobuchopho ezintsha emva kokuba beyekile ukuthatha eli yeza.
I-Siponimod (iMayzent)
I-FDA ivume i-siponimod (iMayzent) yokunyanga iifom ezibuyela umva ze-MS kubantu abadala. Ukuza kuthi ga ngoku, abaphandi abakagqibi naziphi na izifundo ngokusetyenziswa kweli yeza ebantwaneni.
UMayzent ukwiklasi enye yamachiza njengeGilenya. NjengoGilenya, ibhloka i-S1P ekubopheni iiseli ze-T kunye neeseli ze-B. Oku kuyekisa iiseli zomzimba zokuzikhusela ekuhambeni ziye kwingqondo nakumqolo, apho zinokudala umonakalo.
UMayzent uthathwa kanye ngemini. Ukuchonga eyona dosi ifanelekileyo yemihla ngemihla, ugqirha wakho uya kuqala ngokukujonga umakishi wofuzo onokukunceda ukuqikelela impendulo yakho kolu nyango.
Iziphumo zovavanyo lwakho lwemfuza zibonisa ukuba eli yeza lingasebenza kakuhle kuwe, ugqirha wakho uya kukuyalela idosi encinci ukuba uyiqale. Baza kukhulisa kancinci idosi emiselweyo kwinkqubo eyaziwa ngokuba yi-titration. Injongo kukuphucula izibonelelo ezinokubakho ngelixa kuthintelwa iziphumo ebezingalindelekanga.
Ukuba uthatha eli yeza uyeke ukulisebenzisa, imeko yakho inokuba mandundu.
I-Teriflunomide (Aubagio)
I-FDA ivumile ukusetyenziswa kwe-teriflunomide (Aubagio) yokunyanga iifom ezibuyela umva ze-MS kubantu abadala. Akukho zifundo zipapashiweyo ukuza kuthi ga ngoku malunga nokusetyenziswa kweli chiza ebantwaneni.
I-Aubagio ibhloka i-enzyme eyaziwa ngokuba yi-dihydroorotate dehydrogenase (DHODH). Le enzyme ibandakanyeka kwimveliso ye-pyrimidine, ibhloko yokwakha ye-DNA efunekayo kwi-DNA synthesis kwiiseli ze-T nakwiiseli ze-B.
Xa le enzyme ingakwazi ukufikelela kwi-pyrimidine eyaneleyo yokwenza i-DNA, kuthintela ukwakheka kweeseli ezintsha ze-T kunye neeseli ze-B.
Ukuba ufumana unyango nge-Aubagio, ugqirha wakho unokumisela idosi yemihla ngemihla ye-7 okanye ye-14-mg.
Ezinye iziyobisi eziguqula izifo
Ukongeza kula mayeza omlomo, i-FDA ivumile inani lee-DMT ezijojowe phantsi kolusu okanye zinikezwe ngokufakwa ngaphakathi.
Ziquka:
- alemtuzumab (Lemtrada)
- I-glatiramer acetate (iCopaxone, iGlatect)
- I-interferon beta-1 (Avonex)
- I-interferon beta-1a (iRebif)
- I-interferon beta-1b (iBetaseron, iExtavia)
- mitoxantrone (INovantrone)
- natalizumab (iTysabri)
- ocrelizumab (Ocrevus)
- i-peginterferon beta-1a (iPlegridy)
Thetha nogqirha wakho ukuze ufunde okungakumbi malunga nala mayeza.
Umngcipheko onokubakho weziphumo ebezingalindelekanga ezivela kwi-DMTs
Unyango nge-DMTs lunokubangela iziphumo ebezingalindelekanga, kwezinye iimeko ezinzulu.
Iziphumo ezinokubakho zonyango ziyahluka ngokuxhomekeka kuhlobo oluthile lwe-DMT oyithathayo.
Ezinye iziphumo eziqhelekileyo ziquka:
- intloko ebuhlungu
- isicaphucaphu
- ukugabha
- urhudo
- irhashalala
- ukulahleka kweenwele
- ukubetha kwentliziyo kancinci
- ukugungxula ubuso
- ukungaphatheki kakuhle kwesisu
Ii-DMTs zikwanxulunyaniswa nomngcipheko wokonyuka kosulelo, njenge:
- umkhuhlane
- inyumoniya
- isifo sephepha
- amatyathanga
- usulelo oluthile lokungunda
- inkqubela phambili ye-leukoencephalopathy, uhlobo olunqabileyo losulelo lobuchopho
Umngcipheko owandayo wosulelo kungenxa yokuba la mayeza aguqula amajoni akho omzimba kwaye angathoba inani lesifo sokulwa neeseli ezimhlophe emzimbeni.
Ii-DMTs zinokubangela ezinye iziphumo ebezingalindelekanga ezimandundu, ezinjengokwenzakala kwesibindi kunye neempendulo ezibi kakhulu. Ezinye ii-DMTs zinokubangela ukuba uxinzelelo lwegazi lwakho lukhuphuke. Ezinye zinokubangela ukuba izinga lokubetha kwentliziyo yakho licothe.
Gcina ukhumbula ukuba ugqirha wakho uyakucebisa i-DMT ukuba bakholelwa ukuba izibonelelo ezinokubakho zingaphezulu komngcipheko.
Ukuhlala ne-MS engalawulwa ngokufanelekileyo kukwanobungozi obukhulu. Thetha nogqirha wakho ukuze ufunde ngakumbi malunga neziphumo ebezingalindelekanga ezinokubakho kunye nezibonelelo zee-DMTs ezahlukeneyo.
Ii-DMTs azithathwa njengekhuselekileyo kubantu abakhulelweyo okanye abancancisayo.
Ukulawula umngcipheko weziphumo ebezingalindelekanga
Ngaphambi kokuba uqale unyango nge-DMT, ugqirha wakho kufuneka akuvavanye usulelo olusebenzayo, ukonakala kwesibindi, kunye nezinye iingxaki zempilo ezinokuphakamisa umngcipheko wokuthatha amayeza.
Ugqirha wakho unokukukhuthaza ukuba ufumane ugonyo oluthile ngaphambi kokuba uqale unyango nge-DMT. Kuya kufuneka ulinde iiveki ezimbalwa emva kokufumana ugonyo ngaphambi kokuba uqale ukuthatha iyeza.
Ngelixa ufumana unyango nge-DMT, ugqirha wakho unokukucebisa ukuba uphephe amayeza athile, izongezo zesondlo, okanye ezinye iimveliso. Babuze ukuba ngaba akhona amayeza okanye ezinye iimveliso ezinokuthi zinxibelelane okanye ziphazamisane ne-DMT.
Ugqirha wakho kufuneka abeke esweni imiqondiso yeziphumo ebezingalindelekanga ngexesha nasemva konyango nge-DMT. Umzekelo, baya kulandelela uvavanyo lwegazi rhoqo ukujonga ubalo lweeseli zegazi kunye nee-enzymes zesibindi.
Ukuba ucinga ukuba unokufumana iziphumo ebezingalindelekanga, yazisa ugqirha wakho kwangoko.
Ukuthatha
Ii-DMT ezininzi zamkelwe ukunyanga i-MS, kubandakanya iintlobo ezintandathu zonyango lonyango.
Amanye ala mayeza anokukhuseleka okanye afaneleke ngakumbi kubantu abathile kunabanye.
Ngaphambi kokuba uqale ukuthatha i-DMT, cela ugqirha wakho malunga nezibonelelo ezinokubakho kunye nemingcipheko yokuyisebenzisa. Banokukunceda uqonde indlela unyango ezahlukeneyo ezinokuchaphazela ngayo umzimba wakho kunye nembono yexesha elide nge-MS.