Unyango olutsha lweRheumatoid Arthritis kunye noPhando: Uphando lwamva nje

Umxholo

• I-JAK inhibitors zibonelela ngoncedo
• I-BTK inhibitor kuphuhliso
• I-Neurostimulation ibonisa isithembiso
• I-Omega-3 fatty acids inokunceda
• Amayeza e-RA adityaniswe nezibonelelo zempilo yentliziyo
• Ukuthatha

I-rheumatoid arthritis (RA) yimeko engapheliyo ebangela ukudumba ngokudibeneyo, ukuqina kunye nentlungu. Akukho lunyango lwaziwayo ngeRA - kodwa lukhona unyango olufumanekayo ukunceda ukunciphisa iimpawu, ukunciphisa umda kumonakalo odibeneyo, kunye nokukhuthaza impilo elungileyo jikelele.

Njengoko oososayensi beqhubeka nokuphuhlisa kunye nokuphucula unyango lwe-RA, ugqirha wakho unokucebisa utshintsho kwisicwangciso sakho sonyango.

Funda ukuze ufunde ngophando lwamva nje kunye neendlela ezintsha zonyango kule meko.

I-JAK inhibitors zibonelela ngoncedo

Abantu abaninzi abane-RA basebenzisa uhlobo lweziyobisi ezichaphazela isifo se-antirheumatic (DMARD) esaziwa ngokuba yi-methotrexate. Kodwa kwezinye iimeko, unyango lwe-methotrexate kuphela alwanelanga ukulawula iimpawu.

Ukuba uthathe i-methotrexate kwaye usafumana ukumodareyitha ukuya kwiimpawu ezinzima ze-RA, ugqirha wakho unokucebisa ukongeza i-janus kinase (JAK) inhibitor kwisicwangciso sakho sonyango. I-JAK inhibitors zinceda ukumisa iimpendulo zamachiza ezibangela ukudumba emzimbeni wakho. IMethotrexate iyenza le nto, nayo, kodwa ngendlela eyahlukileyo. Abanye abantu, ii-JAK inhibitors zisebenza ngokufanelekileyo.

Ukuza kuthi ga ngoku, uLawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) luvumile iintlobo ezintathu ze-JAK inhibitors zokunyanga i-RA:

• tofacitinib (Xeljanz), yamkelwe ngo-2012
• baricitinib (Olumiant), yamkelwe ngo-2018
• upadacitinib (Rinvoq), yamkelwe ngo-2019

Abaphandi bayaqhubeka nokufunda la mayeza ukuze bafunde indlela abathelekisa ngayo, kunye nezinye iindlela zonyango. Umzekelo, oososayensi kutshanje bafumanise ukuba indibaniselwano ye-methotrexate kunye ne-upadacitinib yayisebenza ngakumbi kune-methotrexate kunye ne-adalimumab yokunciphisa iintlungu kunye nokwenza ngcono ukusebenza kwabantu abane-RA. Ngaphezulu kwe-1,600 yabantu abane-RA abathathe inxaxheba kolu phando.

Uvavanyo lweklinikhi luyaqhubeka ukuphuhlisa ii-inhibitors ezintsha ze-JAK, kubandakanya neyeza lokulinga elibizwa ngokuba yi-filgotinib. Kwilingo lwakutshanje kuvavanyo lonyango lwe-klinikhi, i-filgotinib yafunyanwa isebenze ngakumbi kune-placebo yokunyanga i-RA kubantu ababekhe bazama i-DMARD enye okanye nangaphezulu. Uphando oluthe kratya luyafuneka ukuze kufundwe ukhuseleko lwexesha elide kunye nokusebenza kwesi siyobisi sokulinga.

Ukufunda ngakumbi malunga nezibonelelo ezinokubakho kunye nomngcipheko wokuthatha i-JAK inhibitor, thetha nogqirha wakho. Banokukunceda ufunde ukuba olu hlobo lonyango lunokuba lukhetho olufanelekileyo kuwe.

I-BTK inhibitor kuphuhliso

I-Bruton's tyrosine kinase (BTK) yi-enzyme edlala indima kuphuhliso lokudumba. Ukuthintela isenzo se-BTK, abaphandi baphuhlisile kwaye bavavanya i-BTK inhibitor eyaziwa njenge fenebrutinib.

Izifundo zaphambi kwexesha zibonisa ukuba i-fenebrutinib inokubonelela ngenye indlela yokhetho kwi-RA. Iqela labaphandi bamanye amazwe lisandula ukugqiba ulingo lwesibini lweklinikhi yokufunda ukhuseleko kunye nokusebenza kwefenebrutinib yokunyanga le meko. Bafumanise ukuba i-fenebrutinib yayikhuselekile ngokwamkelekileyo kwaye isebenza kakuhle.

Uphononongo lufumanise ukuba xa idityaniswe ne-methotrexate, i-fenebrutinib yayisebenza ngakumbi kune-placebo yokunyanga iimpawu ze-RA. I-Fenebrutinib yayinamazinga okusebenza afanayo njenge-adalimumab.

Olunye uphando luyafuneka ukuze kufundwe ukhuseleko kunye nokusebenza kwe-fenebrutinib.

I-Neurostimulation ibonisa isithembiso

Abanye abantu bazama amayeza amaninzi ukunyanga iRA, ngaphandle kwempumelelo.

Njengolunye unyango, abaphandi bafunda izibonelelo ezinokubakho kunye nomngcipheko wokukhuthaza i-vagus nerve ukunyanga i-RA. Kule ndlela yonyango, iimpembelelo zombane zisetyenziselwa ukukhuthaza i-vagus nerve. Le luvo inceda ukulawula ukudumba emzimbeni wakho.

Kutshanje oososayensi baqhube isifundo sokuqala somntu sokunyusa i-vagus nerve stimulation kunyango lwe-RA. Bafaka i-neurostimulator encinci okanye isixhobo se-sham kubantu abali-14 abaneRA. Abathandathu kwabo bantu baphathwa nge-vagus nerve stimulation kanye ngemini kangangeeveki ezili-12.

Phakathi kwabathathi-nxaxheba abafumana inkuthazo yemithambo-luvo yemihla ngemihla, abathathi-nxaxheba abane kwabathandathu bafumana amava okuphucula kwiimpawu zeRA. Abathathi-nxaxheba abambalwa bafumana iziganeko ezibi ngexesha lonyango, kodwa akukho nasinye seziganeko ezichaziweyo ezazinzulu okanye ezisisigxina.

I-Omega-3 fatty acids inokunceda

Ukongeza ekuthatheni amayeza amiselweyo, uphando lubonisa ukuba ukongeza isongezelelo se-omega-3 kwindlela yakho yemihla ngemihla kunokunceda ukunciphisa umda weempawu zeRA.

Ukusetyenziswa kwe-omega-3 fatty acid kunxulunyaniswe nokunciphisa ukudumba emzimbeni. Xa abaphandi abavela kwiDyunivesithi yaseHouston baphonononge uphando nge-omega-3 yokuxhasa, bafumana izilingo ezingama-20 zeklinikhi ezijolise kwi-RA ngokukodwa. Kwizilingo ezili-16 kwezingama-20, ukuxhaswa kwe-omega-3 kwakudityaniswa kuphuculo olukhulu kwiimpawu zeRA.

Uphando lwamva nje lufumene ikhonkco phakathi kokongezwa kwe-omega-3 kunye nokuncitshiswa kwesifo kubantu abane-RA. Kwintlanganiso ye-ACR / ARP yonyaka ka-2019, abaphandi baxela iziphumo zovavanyo lobhaliso olude lwe-1,557 yabantu abane-RA. Abathathi-nxaxheba abaye baxela ukuthatha izongezo ze-omega-3 babenamanqaku asezantsi emisebenzi yesifo, amalungu adumbayo, kunye namalungu angaphantsi kabuhlungu ngokomndilili kunabo bangakhange bathathe izongezo ze-omega-3.

Amayeza e-RA adityaniswe nezibonelelo zempilo yentliziyo

Amanye amayeza eRA anokufumana izibonelelo zentliziyo yakho, kunye namalungu akho. Ngokwezifundo ezibini ezitsha ezichazwe kwiNtlanganiso yoNyaka ye-ACR / ARP yonyaka, loo mayeza aquka imethotrexate kunye nehydroxychloroquine.

Kwisifundo esinye, abaphandi balandela amagqala angama-2,168 ane-RA ukusuka ngo-2005 ukuya ku-2015. Bafumanise ukuba abathathi-nxaxheba abafumana unyango nge-methotrexate bebengenamathuba okuba bafumane iziganeko zentliziyo, ezifana nokuhlaselwa sisifo sentliziyo okanye ukubetha. Abathathi-nxaxheba abafumene i-methotrexate nabo babengenamathuba okuba balaliswe esibhedlele ngenxa yokusilela kwentliziyo.

Kwesinye isifundo, abaphandi baseCanada bahlalutya idatha yobhaliso eqokelelwe kumaqela amathathu: abantu abane-RA, abantu abane-systemic lupus erythematosus (SLE), kunye nolawulo olusempilweni olungenayo imeko. Abantu abaneRA okanye i-SLE abanyangwe ngehydroxychloroquine babenomngcipheko omncinci weziganeko zentliziyo, ezinje ngokuhlaselwa sisifo sentliziyo okanye ukubetha.

Ukuthatha

Ukuphumelela kwesayensi yezonyango kunokunceda abaphandi ukuba baphucule unyango esele lukhona kunye nokuphuhlisa iindlela ezintsha zonyango lokulawula i-RA.

Ukuze ufunde okungakumbi malunga nonyango lwamva nje lweRA, thetha nogqirha wakho. Banokukunceda uqonde izibonelelo ezinokubakho kunye nomngcipheko wokuhlengahlengisa isicwangciso sakho sonyango. Banokucebisa notshintsho kwindlela yokuphila, njengokungatshayi okanye ukuvutha, ukukunceda ukuba ube nokona kulungileyo kunye nomgangatho wobomi obunale meko.